Bone Densitometry Insurance and Scheduling

Scheduling Bone Densitometry

1. Medicare and insurance guidelines listed below.
2. Call 859.275.2100 to schedule your patient
3. Our order forms are available or you may use your own orders which include a provider signature.
4. Please specify:
   1. Hip and lumbar
   2. Vertebral fracture assessment
   3. Wrist – (used in patients with hyperparathyroidism)

Bone Densitometry Medicare/Insurance Guidelines

1. Post menopausal (estrogen deficient) individuals who are at risk for osteoporosis – current estrogen replacement is not a contraindication.
2. Vertebral fractures, osteopenia or osteoporosis on vertebral x-ray
3. Primary hyperparathyroidism
4. Long term steroid therapy (7.5 mg or higher prednisone > 3 months)
5. History of prostate cancer with hormone therapy
6. Monitoring response to osteoporosis drug therapy
7. Baseline study after screen by other technique (ultrasound)

Coverage for follow-up bone densitometry is every TWO YEARS unless medically necessary to measure more frequently.

DEXA at any other site within the past two years will probably be denied as medically unnecessary.