The bone density test, most commonly performed as a Dual-Energy X-ray Absorptiometry (DEXA or DXA) scan, precisely measures the mineral content of your bones. This test is important for diagnosing osteoporosis, a condition characterized by low bone mass and increased fracture risk. The primary purpose of a DEXA scan is to assess your fracture risk and to monitor the effectiveness of treatment for bone loss. Finding an appropriate location for this imaging test requires understanding the technology, knowing where these services are offered, and navigating the necessary logistical steps.
Understanding the DEXA Scan
The DEXA scan uses a small dose of X-ray energy to measure Bone Mineral Density (BMD), focusing on the hip and spine, which are common sites for osteoporotic fractures. The procedure is non-invasive and takes about 15 to 30 minutes to complete. Results are provided as a numerical measurement of BMD, primarily through the T-score and the Z-score.
The T-score is the primary diagnostic value, comparing your bone density to that of a healthy young adult of the same sex. A T-score of -1.0 or higher is considered normal. A score between -1.0 and -2.5 suggests low bone mass, known as osteopenia, and a score of -2.5 or lower indicates osteoporosis.
The Z-score compares your bone density to the average density of people who are your same age, sex, and body size. A Z-score significantly below the average for your age group, typically below -2.0, may suggest that factors other than age are contributing to bone loss. While the T-score is used for diagnosis, the Z-score helps determine if an underlying medical condition is causing the density issue, prompting further medical investigation.
Primary Testing Locations
Diagnostic DEXA scans are performed at several types of medical facilities. Hospital radiology departments frequently offer DEXA scanning, which is convenient if you are already seeing a specialist or receiving other medical services within that system. These locations are often equipped to handle complex or inpatient cases but may have longer scheduling wait times.
Standalone diagnostic imaging centers are another common and accessible option for a bone density test. These centers specialize in various imaging services, including DEXA, and often offer more flexible appointment times or quicker scheduling than busy hospital settings. They focus on outpatient care and provide a streamlined experience.
Some specialized medical practices, such as those focusing on endocrinology or rheumatology, may have their own DEXA equipment on-site. This is particularly convenient if your physician is already managing your bone health, as the scan and consultation can occur in the same location. Some breast centers also offer DEXA scanning, allowing the bone density test to be scheduled concurrently with a routine mammogram.
Navigating Referrals and Coverage
To get a diagnostic DEXA scan, you will almost always need a physician’s referral, especially when using insurance coverage. This referral, which may come from a primary care doctor or a specialist, establishes the medical necessity of the test. Guidelines recommend routine screening for all women aged 65 and older and men aged 70 and older, but younger individuals with risk factors also qualify.
Common risk factors justifying a scan for younger patients include a history of fractures, long-term use of medications like steroids, low body weight, or a family history of osteoporosis. Insurance providers, including Medicare, usually cover the cost of a DEXA scan every two years for high-risk groups who meet specific criteria. Coverage policies vary significantly between private insurance plans, and some may require prior authorization from your insurer before the test is performed.
It is important to contact your insurance company before scheduling to verify coverage and understand any potential out-of-pocket costs, such as copays or deductibles. If you do not meet the medical necessity criteria for insurance coverage, or if your plan denies the claim, many imaging centers offer a self-pay option. Once your referral and coverage are confirmed, you can schedule the appointment at your chosen facility.