From the July 2015 issue of HealthCare Business News magazine


Since fewer practices are offering it, there has been a small shift to hospitals but it’s not enough to compensate for the loss, and hospitals are often far from patients’ homes. The ISCD found that there was a 12 percent decrease from 2008 to 2012 in older women with Medicare receiving DXA testing.

HealthCare Business News asked CMS what it thinks is a potential solution to fewer women undergoing DXA testing. The agency declined to comment on that, but suggested that interested parties submit comment to the forthcoming 2016 Physician Fee Schedule proposed rule.


In addition to fewer practices conducting the exams, many that still offer it are uncertain about the current screening guidelines. The U.S. Preventive Services Task Force recommends screening for osteoporosis in women 65 years and older and in younger women with a fracture risk equal to or greater than that of a 65-year-old white woman with no additional risk factors.

A new study conducted by the University of California Davis Health System investigating the use of DXA assessed the electronic health records of 51,000 women from 40 to 85 years of age who received health care in the Sacramento area. It found that over a seven-year period more than 42 percent of eligible women from 65 to 74 years of age were not screened, nor were almost 57 percent of women older than 75. However, almost 46 percent of low-risk women between the ages of 50 to 59, and 59 percent of those from ages 60 to 64, were screened.

The researchers believe that this is because physicians usually think about age-related bone loss when women enter menopause at around 50, but fail to consider patients’ risk factors. The solution to that might be electronic health record systems that alert physicians at the point-of-care when screening is needed and when it can be postponed.

But there is not yet a widespread, viable solution for the declining number of physicians offering the service. However, some people in the industry believe that other bone density tests, including peripheral DXA, may help.

Is there another option?
Although DXA is the gold standard for bone density testing, it’s not the only modality that can assess bone density. Lone Oak Medical Technologies in Pennsylvania received FDA approval in 2012 for its peripheral DXA device, accudxa2, which measures bone density using the patient’s finger.

Peripheral machines measure the peripheral skeleton and assess the heel, forearm or finger but the traditional, central DXA machines are designed to measure central skeletal sites and assess the lumbar spine and hip. In addition, the central machines are larger and more expensive, but the accudxa2 is the size of a breadbox and costs significantly less. In addition, reimbursement for each exam averages at about $30 throughout the U.S.

July 2015 Magazine

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