Biochemical Markers of Bone Remodeling

Aetna considers measurement of a broad range of biochemical bone turnover markers (e.g., P1NP, CTX/NTX, osteocalcin, sclerostin, RANKL, TRAP, cathepsin K, pyridinoline/deoxypyridinoline, bone sialoprotein, IGF‑1, osteoprotegerin, etc.), collagen crosslinks, and plasma homocysteine experimental and investigational and therefore not covered for evaluating fracture risk, diagnosing/monitoring aseptic loosening or osteolysis after total joint arthroplasty, use in persons on serotonergic antidepressants, or for screening/management of bisphosphonate‑related jaw osteonecrosis, CKD, osteogenesis imperfecta, or other indications. Key requirement: none—these tests are considered to have unestablished clinical value and are not payable.

"No biochemical markers of bone remodeling are identified in this Clinical Policy Bulletin as established/covered for evaluation of fracture risk; Aetna considers measurement of the listed bone turn..."