BONE DENSITY GUIDELINES: FOR ORDERING SCREENING BONE DENSITY AND TRABECULAR BONE SCORE EXAMS.
— March 2023
Bone Density (DXA) scans and Trabecular Bone Score (TBS) exams are important tools used to measure bone loss and the bone’s internal micro-architecture and strength. They are commonly used to diagnose osteoporosis and to assess an individual’s risk for osteoporotic fractures. The exam is simple, quick and noninvasive. It’s also the most commonly used and the standard method for diagnosing osteoporosis and bone fracture risk.
Patients must meet one or more of the following criteria for a screening DXA to be covered:
Bone Density (DXA) scans and Trabecular Bone Score (TBS) exams are important tools used to measure bone loss and the bone’s internal micro-architecture and strength. They are commonly used to diagnose osteoporosis and to assess an individual’s risk for osteoporotic fractures. The exam is simple, quick and noninvasive. It’s also the most commonly used and the standard method for diagnosing osteoporosis and bone fracture risk.
Patients must meet one or more of the following criteria for a screening DXA to be covered:
A woman at risk for osteoporosis who is estrogen deficient
A person whose X-rays show possible osteoporosis, osteopenia or vertebral fractures
A person taking prednisone or steroid-type medications, or is planning to take them
A person diagnosed with hyperpara thyroidism
A person being monitored during drug therapy
It is important that the criteria a patient meets be indicated on the DXA order.
Medicare and most insurance plans will only cover a Screening DXA once every two years. However, there are diagnoses that allow for the frequency of a DXA sooner than the 24 months. These include the following:
Cushing Syndrome
Osteoporosis without current pathological fracture (specifyanatomical site)
Long term (current) use of steroids
Long term (current) use ofbisphosphonates
Other specified disorders of bone density and structure (specify anatomical site)