A Bone Density Scanner provides amazing information that’s very useful and can help prevent bone fracture and osteoporosis. By providing bone density scans, you’re not just providing another screening, you’re actually helping people to prevent bone health issues down the line. And there are so many technologies available nowadays to get this accomplished. And because Medicare and insurance companies see the value in preventive diagnosis of a bone density scanner, your ROI (Return On Investment) should always be on the positive side. But it’s not always just about money and bone density reimbursement; having a Bone Density Scanner also means that you’re providing an higher level of patient service.
NIH suggests that all women over age 65 should have a bone density test. (Visit NIH’s resource on Bone Health) WebMD also recommends this exam for women, and adds another roster of people who should be getting bone density scans such as older men, men with other risk factors for osteoporosis, people who have hyperparathyroidism, and those who takes corticosteroids. (Visit WebMD’s done density site) But it is also recommended for younger people to do scans every now and then to make sure their scores are within normal range for their age group.
Bone Density Scanners use very small amounts of radiation to check the density of ones bones and produces a T-score. This score is used to compare the strength of your bones against the population. Recently we are finding more and more younger people (especially in women) who have osteoporosis or osteopenia. This could be a result of physical inactivity or food choices that are available nowadays but this increases the range of people who should get routine bone density scans. And there are ways to make this an easy transition too.
If you bring up a bone density scan and if your patient feels like they have to lie down for a full body scan, some patients might not feel comfortable right away, especially if they’re younger. But if you have one of these small ultrasound units that can measure bone density on a small area on your arm, allowing you to get a sample bone density reading without making patient get on the full sized unit. This small device shown here fascinated me recently. Upon discovery, I immediately sat down and asked for a test run. The technician measured the bone density on my left arm within 5 minutes including all prep and the actual result displaying. This low-cost unit (with medicare reimbursement) can be used to screen patients quickly without having to do a full-sized bone density scan. And if you suggest a full-sized bone density scan based on low T-score on this smaller scan, who will really say no then?
Now, let’s talk money. I hear reimbursement for a bone density scan did go down since 2006 when it was peaked at $139 per test, on average, to almost half a few years back but Affordable Care Act did increase payout back up before congress brought it down to $56 level in 2012. These reimbursements will go up and down. But let’s assume at $56 range which is one of lowest average we had in past decade. And let’s say if you can manage to do two scans per day, based on 20 business days per month, you’re going to earn $26,880 on reimbursement alone. While this doesn’t sound enough for a brand new GE unit that cost $40,000, you can always get a refurbished one at about $20,000 ~ $29,000.
‘Because someone once told me the best treatment is Prevention’
And that’s all we’re going to actually discuss regarding money. Instead, I’d like to spend the last paragraph talking about patient care. A true ROI of a Bone Density Scanner and many other similar modalities are not based on reimbursement and how much we can make from one machine. It’s quality of care. If you always chase reimbursement and healthcare trends based on Medicare, you’ll never achieve true quality of care. Because Medicare reimbursement and quality patient care rarely goes together. By having a Bone Density Scanner in your office, you’re assuring your patient that you are providing different screenings to help prevent future illness. Because someone once told me the best treatment is prevention and we need more ways to prevent illness from happening rather than trying to patch things up afterwards. Perhaps a Bone Density Scanner isn’t another tool to just make money. Perhaps it’s a bit more than that.
There are many different ways to run a practice. And money is important as is ROI (extremely important). But in my eyes, I see two different kinds of ROI: one with a dollar sign, and one without. And perhaps, they’re both important.
[Future Article: When running a practice, should you always follow the wind?]
Here are correct codes for Bone Density reimbursement:
– 77080 for an axial or central DXA study of the hips, pelvis, and spine.
– 77081 for an appendicular skeleton or peripheral scan of one or more sites, such as the wrist or heel.
– 77082 for a vertebral fracture assessment.
– 76499 for an unlisted diagnostic radiographic procedure, such as a DXA study of body composition, which Medicare and other insurers generally do not cover.
*Information on codes & reimbursement calculation harvested from: Medical Economcis