Bone Mass Measurements

Aetna covers bone mass measurements—primarily DXA for monitoring osteoporosis drug therapy—and also for members on ≥5 mg/day prednisone (or equivalent) >3 months, long-term anticonvulsant or aromatase inhibitor therapy, and those with celiac sprue, but repeat testing is generally limited to every 2 years. More frequent testing is only allowed for a confirmatory baseline when switching techniques, for monitoring during prolonged glucocorticoid/anticonvulsant therapy or uncorrected primary hyperparathyroidism, and simultaneous axial/appendicular scans are covered only in specific situations (baseline after peripheral detection, axial artifacts, or uncorrected hyperparathyroidism); other indications are not supported.

"Finite element analysis (FEA) / CT-based methods: while promising for fracture prediction, "FEA cannot be used to diagnose osteoporosis, initiate therapy, or monitor therapy" and these techniques "..."