Bone Densitometry

Are Your Patients Eligible for a Medicare Rebate?

Rebates are available for many, but not all, patients who are referred for a Bone Mineral Densitometry scan. To be eligible for a rebate, patients must meet one of the following criteria which must be clearly indicated on the referral:

Item Number 12306

Bone Densitometry, using dual energy X-ray absorptiometry, involving the measurement of 2 or more sites (including interpretation and reporting), for:

  • Confirmation of a presumptive diagnosis of low bone mineral density made on the basis of 1 or more fractures occurring after minimal trauma; or
  • Monitoring of low bone mineral density proven by bone densitometry at least 12 months previously;

Other than a service associated with a service to which item 12312, 12315 or 12321 applies.

For any particular patient, once only in a 24 month period.

Item Number 12312

Bone Densitometry, using dual energy X-ray absorptiometry, involving the measurement of 2 or more sites (including interpretation and reporting), for diagnosis and monitoring of bone loss associated with one or more of the following:

  • Prolonged glucocorticoid therapy;
  • Any condition associated with excess glucocorticoid secretion;
  • Male hypogonadism;
  • Female hypogonadism lasting more than 6 months before the age of 45;

Other than a service associated with a service to which item 12306, 12315 or 12321 applies.

For any particular patient, once only in a 12 month period.

Item Number 12315

Bone Densitometry, using dual energy X-ray absorptiometry, involving the measurement of 2 or more sites (including interpretation and reporting), for diagnosis and monitoring of bone loss associated with one or more of the following conditions:

  • Primary hyperparathyroidism;
  • Chronic liver disease;
  • Chronic renal disease;
  • Any proven malabsorptive disorder;
  • Rheumatoid arthritis;
  • Any condition associated with thyroxine excess;

Other than a service associated with a service to which item 12306, 12312 or 12321 applies.

For any particular patient, once only in a 24 month period.

Item Number 12320

Bone Densitometry, using dual energy X-ray absorptiometry or quantitative computed tomography, involving the measurement of 2 or more sites (including interpretation and reporting), for measurement of bone mineral density, if:

  • The patient is 70 years of age or over; and
  • Either:
    • The patient has not previously had bone densitometry; or
    • The t-score for the patient’s bone mineral density is -1.5 or more;

Other than a service associated with a service to which item 12306, 12312, 12315, 12321 or 12322 applies.

For any particular patient, once only in a 5 year period.

Item Number 12321

Bone Densitometry, using dual energy X-ray absorptiometry, involving the measurement of 2 or more sites at least 12 months after a significant change in therapy (including interpretation and reporting), for:

  • Established low bone mineral density; or
  • Confirming a presumptive diagnosis of low bone mineral density made on the basis of one or more fractures occurring after minimal trauma;

Other than a service associated with a service to which item 12306, 12312 or 12315 applies.

For any particular patient, once only in a 12 month period.

Item Number 12322

Bone Densitometry, using dual energy X-ray absorptiometry or quantitative computed tomography, involving the measurement of 2 or more sites (including interpretation and reporting) for measurement of bone mineral density if:

  • The patient is 70 years of age or over; and
  • The t-score for the patient’s bone mineral density is less than -1.5 but more than -2.5;

Other than a service associated with a service to which item 12306, 12312, 12315, 12320 or 12321 applies.

For any particular patient, once only in a 2 year period.

Item Number 1111

This is charged for Screening Bone Densitometry, which is not eligible for Medicare rebate.

If you would like further information, please call 132 336