Z78.0: Asymptomatic menopausal state
Z78.0, asymptomatic menopausal state, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 2 HCPCS Level II codes, including G0130 (Single energy x-ray absorptiometry (sexa) bone density…), J1740 (Injection, ibandronate sodium, 1 mg). The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with Z78.0 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0130 | Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) | Special coverage instructions apply | — | 2 |
| J1740 | Injection, ibandronate sodium, 1 mg | Carrier judgment | — | 1 |
Medicare policy articles listing Z78.0
- A52421: Billing and Coding: Ibandronate Sodium (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes)
- A59040: Billing and Coding: Bone Mass Measurement (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36460, L39268
- A57132: Billing and Coding: Bone Mass Measurement (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L36460, L39268
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Frequently asked questions
Does Medicare cover Z78.0 (Asymptomatic menopausal state)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list Z78.0 as a covered diagnosis for 2 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 Z78.0?
The Level II codes from the policies most specific to this diagnosis are G0130 (Single energy x-ray absorptiometry (sexa) bone density…, 2 articles); J1740 (Injection, ibandronate sodium, 1 mg, 1 article). Code choice depends on the item supplied; check each code's descriptor.
Which Medicare policy articles list Z78.0?
A52421 (Billing and Coding: Ibandronate Sodium); A59040 (Billing and Coding: Bone Mass Measurement); A57132 (Billing and Coding: Bone Mass Measurement).
What is ICD-10-CM code Z78.0?
Z78.0 is the ICD-10-CM code for asymptomatic menopausal state, in category Z78 (Other specified health status), chapter 22: Factors influencing health status and contact with health services.
Next steps
- Run a reimbursement report for a device billed under G0130
- Watch G0130 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0130
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 22: Factors influencing health status and contact with health services · All diagnoses · HCPCS lookup