Bone Turnover Markers for Diagnosis and Management of Osteoporosis and Diseases Associated with High Bone Turnover

This policy covers measurement of serum or urine bone turnover markers (by HPLC or immunoassay) as adjunctive tests to DXA for diagnosis, fracture-risk assessment, monitoring and management of osteoporosis and related high-turnover bone diseases (e.g., Paget disease, primary hyperparathyroidism, renal osteodystrophy). Coverage is limited to indications with demonstrated clinical validity and utility—markers must independently add to BMD or change management to improve outcomes; they are not a substitute for DXA, are subject to significant biological and pre-analytical variability, and many uses remain experimental/investigational.

"Use serum or urine bone turnover marker tests (by HPLC or immunoassay) to supplement bone mineral density (BMD) measurement in the diagnosis of osteoporosis."

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