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Osteoporosis Screening Recommendation Updated

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  • In Coding
  • January 28, 2011
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As many as one in two postmenopausal women in the United States is at risk for an osteoporosis-related fracture. Given that, the U.S. Preventive Services Task Force (USPSTF) is now recommending routine screening for osteoporosis in women aged 65 and older, as well as in certain younger women.
Specifically, this recommendation includes women of all racial and ethnic groups 65 and older who do not have a history of an osteoporotic fracture, osteoporosis secondary to another condition, or other specific indication for bone measurement testing, as well as younger women who are at equal or greater risk for osteoporosis than the average 65-year-old women who has no additional risk factors.
Osteoporosis is a condition that occurs when bone tissue thins or develops small holes, which can cause pain, broken bones and loss of body height.
The USPSTF suggests primary care practices offer or provide routine bone density screening to high risk groups, but notes there is a lack of evidence about how often screening should be repeated.
The most commonly used screening test is dual-energy X-ray absorptiometry (DXA) of the hips, pelvis and lumber spine (CPT® 77080). Other screening tests include single energy X-ray absorptiometry (SEXA) (HCPCS Level II G0130) and computed tomography (CPT® codes 77078-77079).
Medicare currently covers bone density screening once every 24 months (more often if medically necessary). Medical record documentation maintained by the treating physician must clearly indicate the medical necessity for ordering bone mass measurements. For dates of service on or after Jan. 1, 2011, there is no copay or coinsurance for bone density screening, pursuant to the Patient Protection and Affordable Care Act of 2010.
Intervention for osteoporosis includes adequate calcium and vitamin D intake and weight-bearing exercise. Treatment to reduce fracture risk in women with low bone mineral density and no previous fractures includes multiple U.S. Food and Drug Administration–approved therapies, such as bisphosphonates, parathyroid hormone, raloxifene, and estrogen.
The USPSTF recommendation summary was first published in the Annals of Internal Medicine, Jan. 18, 2011. A summary of evidence, the full recommendation statement, and supporting documents are available on the USPSTF website.

Certified Internal Medicine Coder CIMC

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