A Dual-Energy X-ray Absorptiometry scan, commonly known as a DEXA scan, is a non-invasive imaging test that uses a small dose of ionizing radiation to measure bone mineral density (BMD), primarily in the hips and spine. The principal purpose of a DEXA scan is to screen for and diagnose conditions like osteoporosis and osteopenia, which involve the progressive loss of bone mass. Measuring BMD helps healthcare providers determine an individual’s risk of experiencing a future bone fracture.
The Necessary First Step: Obtaining a Physician Referral
A medical order from a licensed healthcare provider is usually necessary for a DEXA scan. This requirement is in place because the scans are covered by insurance only when they are deemed medically necessary.
Many types of physicians commonly order this test, including primary care practitioners, endocrinologists who specialize in hormone-related disorders, and rheumatologists who treat musculoskeletal conditions. Women aged 65 and older and men aged 70 and older generally qualify for routine screening as a preventative measure.
Patients who are younger may also qualify if they have specific risk factors, such as a history of a fracture caused by a minor fall. Other qualifying conditions include long-term use of medications like corticosteroids, which accelerate bone loss, or having a medical condition like primary hyperparathyroidism or rheumatoid arthritis. Women who have experienced early menopause or who are deemed estrogen-deficient may also be referred for a scan.
Types of Facilities That Offer DEXA Scans
Once a referral is secured, the DEXA scan can be performed at several different types of medical facilities.
Hospital Radiology Departments
These are common locations, but scheduling can be less flexible, and costs are often higher.
Outpatient Diagnostic Imaging Centers
These centers specialize solely in procedures like X-rays, MRIs, and DEXA scans. They frequently offer greater convenience, including extended hours or weekend appointments, and often advertise lower self-pay and insurance-negotiated rates compared to hospital-based services.
Specialized Clinics
Some specialized clinics, particularly those focused on bone health, endocrinology, or sports medicine, may have their own DEXA equipment. These centers may offer whole-body composition analysis in addition to the standard bone mineral density assessment of the spine and hip.
The choice of facility often comes down to a balance between cost, scheduling availability, and the specific type of scan required.
Understanding Insurance Coverage and Costs
Most commercial insurance plans and government programs like Medicare Part B cover the scan for individuals who meet specific risk criteria. Pre-authorization from the insurance provider is often a necessary step to ensure the claim will be paid and to avoid unexpected out-of-pocket expenses.
Costs for the procedure can vary significantly depending on the type of facility performing the scan, with non-hospital outpatient centers frequently offering lower rates. For billing purposes, the facility will use specific Current Procedural Terminology (CPT) codes. Code 77080 is used for the axial skeleton (hips and spine), 77081 for peripheral sites like the forearm, and 77085 is used if the scan includes a vertebral fracture assessment.
If a patient is uninsured, many outpatient imaging centers offer a discounted self-pay rate. Patients should inquire about the total cost upfront and explore these options to manage expenses.
Preparing for Your DEXA Scan Appointment
The most important preparation is to avoid taking any calcium supplements, including multivitamins and calcium-containing antacids, for a full 24 hours before the appointment. Calcium can temporarily interfere with the radiation absorption measurement, which can lead to an inaccurate BMD reading.
Patients should wear loose-fitting, comfortable clothing that does not contain any metal, such as zippers, buttons, or underwire. Metal objects, including jewelry, watches, and belts, must be removed before the scan, as they can obstruct the X-ray beam and distort the final images.
The procedure typically lasts 10 to 20 minutes and involves lying still on a padded table while the scanning arm passes over the body.