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