Bone Density: Time to Get It Tested

Bone Mass Measurement (BMM), or bone density screening is a test that identifies bone mass, detects bone loss, and may determine bone quality. BMM can be performed with a bone 'densitometer' or an approved bone 'sonometer system.' Bone densitometry uses an X-ray or some other form of radiation, and the test will determine your bone density according to the rate at which this radiation is absorbed by your bones. There are usually three methods of testing: a stationary machine kept in one location, such as your doctor’s office or a hospital; a mobile unit, such as you see with mammography units, or with a portable machine. Bone sonometers are ultrasound machines and do not use radiation. You often see these machines in doctors’ offices. This is the same ultrasound technique used for gallbladders, bladders, etc.

Medicare may cover BMM screening once every two years (at least 23 months have passed since the month the last covered BMM was performed) or more often when medically necessary for persons who are at risk for osteoporosis and meet other conditions. This test is free (deductible and coinsurance/copayment are waived) if your doctor or health care provider accepts assignment. To 'accept assignment' means your doctor or health care provider or suppler has a signed agreement to be paid directly by Medicare and to accept the Medicare approved amount. They cannot bill you for any more than the Medicare deductible and coinsurance.

Medicare covers bone mass measurement when:

• It is ordered by a physician or qualified health care practitioner who is treating you, following an evaluation of the need for the BMM
• The patient meets one of the following conditions:
  • Is a woman whose physician/qualified non-physician practitioner treating her finds the patient to be estrogen-deficient and at clinical risk for osteoporosis based on medical history and other findings
  • Is an individual with vertebral abnormalities shown by an X-ray that indicate osteoporosis, osteopenia (when bones have decreased calcification, decreased density or reduced mass) or vertebral fracture
  • Is receiving (or expected to receive) glucocorticoid (steroid) therapy at certain dosages for more than three months
  • Has primary hyperparathyroidism
  • Is being monitored to assess the response to or effectiveness of an FDA-approved osteoporosis drug therapy

As our bodies age, our bones can become increasingly porous, brittle, and can fracture. Decrease in bone density can be reduced with diet and exercise and fall prevention. Some medications may also be used to treat decreased bone mass. Talk to your doctor to see if you need a BMM.

For questions about Railroad Medicare coverage, please call our Beneficiary Contact Center at 800-833-4455 or for TTY, call 877-566-3572. Representatives are available Monday through Friday from 8:30 a.m. to 7 p.m. ET. We also invite you to visit our Facebook page called 'My RR Medicare' at www.facebook.com/myrrmedicare.