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Osteoporosis and Bone Density Tests

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Bone density tests (also called bone mineral density tests or bone scans) evaluate the strength of your bones by measuring a small part of one or a few bones. Knowing the strength of your bones can help your doctor recommend prevention steps and osteoporosis  medication, if needed, to prevent bone loss and fractures.

Who Should Have a Bone Density Test?

According to National Osteoporosis Foundation guidelines, there are several groups of people who should consider bone density testing:

  • All postmenopausal women below age 65 who have risk factors for osteoporosis.
  • All women aged 65 and older.
  • Women with medical conditions associated with osteoporosis. Your health care provider can tell you if you have a medical condition associated with osteoporosis.
  • Men age 70 or older.
  • Men ages 50-69 with risk factors for osteoporosis or medical conditions associated with osteoporosis.

 

Does Insurance Cover the Cost of a Bone Density Test?

Many health insurance companies cover the cost of a bone density test, as does Medicare. But you need to check ahead of time to see if the test is covered under your specific plan (or if you qualify according to Medicare's criteria for who is eligible for testing).

Most health insurers will pay for this test if you have one or more risk factors such as:

  • A fracture
  • You are postmenopausal
  • You are not taking estrogen at menopause
  • You are taking medications that cause bone thinning

Medicare covers bone density testing for the following individuals aged 65 and older:

  • Estrogen-deficient women at risk for osteoporosis
  • Individuals with spinal abnormalities
  • Individuals receiving, or planning to receive, long-term glucocorticoid (steroid) therapy
  • Individuals with primary hyperparathyroidism
  • Individuals being monitored to assess the response or efficacy of an approved osteoporosis drug therapy

Medicare permits individuals to repeat bone density testing every two years.

What Types of Bone Density Tests Are Available?

There are several different machines used to measure bone density. "Central" machines measure bone density in the hip, spine, and total body. "Peripheral" machines measure bone density in the finger, wrist, kneecap, shinbone, and heel. Here are some of the different types of bone density tests:

  • DXA (Dual Energy X-ray Absorptiometry) measures the spine, hip, or total body.
  • pDXA (Peripheral Dual Energy X-ray Absorptiometry) measures the wrist or heel.
  • SXA (single Energy X-ray Absorptiometry) measures the wrist or heel.
  • QUS (Quantitative Ultrasound) uses sound waves to measure density usually at the heel.
  • QCT (Quantitative Computed Tomography) is most commonly used to measure the spine, but can be used at other sites.
  • pQCT (Peripheral Quantitative Computed Tomography) measures the wrist.
  • RA (Radiographic Absorptiometry) uses an X-ray of the hand.

With the information obtained from a bone density test, you and your health care provider can decide the necessary prevention or treatment steps that are best for you.

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