A Dual-Energy X-ray Absorptiometry (DEXA) scan is a non-invasive imaging test that uses low-dose X-rays to precisely measure bone mineral density (BMD). This procedure is the standard method for diagnosing osteoporosis, a condition characterized by weakened bones, and assessing the risk of future fractures. The scan evaluates bone density, typically in the hip and spine, providing physicians with a clear picture of bone health. Determining whether the test is medically appropriate is the first step in obtaining this screening.
Identifying Candidates for a DEXA Scan
The need for a DEXA scan is determined by established medical guidelines focusing on age and specific risk factors for bone loss. All women aged 65 and older, and all men aged 70 and older, are generally recommended to undergo screening as a preventative measure. This age threshold accounts for the natural decline in bone strength that occurs over time.
Screening is also recommended for younger individuals with an elevated risk profile. This includes postmenopausal women under 65 who possess certain risk factors, such as a parental history of hip fracture or a personal history of a fragility fracture after age 50. Individuals with low body weight, defined as less than 127 pounds, are also often candidates for earlier testing.
Certain medical conditions and long-term medication use can significantly accelerate bone density loss. Conditions like hyperparathyroidism, rheumatoid arthritis, and certain endocrine disorders increase the risk of osteoporosis. The long-term use of specific medications, particularly glucocorticoids (steroids), certain types of cancer drugs, and some anticonvulsants, also make screening advisable.
Types of Facilities Providing DEXA Services
DEXA scans are performed across a variety of medical settings, ranging from large hospital systems to specialized outpatient clinics. The most common locations are the radiology departments within hospitals, which are equipped with the central DEXA machines necessary to measure the hip and spine. These centers typically offer comprehensive imaging services and have radiologists available to interpret the results.
Dedicated outpatient imaging centers are another widely available option for receiving a DEXA scan. These facilities often specialize in diagnostic testing, which can result in lower costs and more flexible scheduling options compared to a hospital environment. Many centers are designed to provide a convenient patient experience focused purely on imaging.
Specialized clinics, such as those focusing on orthopedics, rheumatology, or women’s health, frequently house their own DEXA equipment. Obtaining a scan in these settings offers the advantage of having the test performed in the same location as the referring specialist. In some communities, smaller, portable peripheral DEXA devices (pDXA) measure bone density in the wrist, heel, or finger, and may be found in mobile health vans or certain pharmacies for initial screening.
Navigating the Referral and Appointment Process
Securing a DEXA scan typically begins with a consultation with a healthcare provider, such as a primary care physician or a specialist. The physician reviews the patient’s medical history, risk factors, and current medications to determine if screening is medically justified. If a scan is deemed necessary, the physician issues a prescription or a formal referral, which is required by the imaging facility.
Once the referral is obtained, the patient contacts an imaging facility to schedule the appointment. It is advisable to have the physician’s office send the referral directly to the chosen center to streamline the check-in process. When booking, patients should inquire about preparation instructions, although the procedure generally requires minimal effort.
Patients are instructed to avoid taking calcium supplements for at least 24 hours before the test to prevent interference with the bone density readings. They are also advised to wear loose, comfortable clothing without metal zippers, buttons, or belts, as these items may interfere with the X-ray images. The scan itself is a quick, non-invasive procedure, lasting between 10 and 30 minutes, during which the patient lies still on a padded table.
Factors Affecting Scan Cost and Coverage
The out-of-pocket cost for a DEXA scan can vary significantly, generally ranging from approximately $100 to over $300 for individuals without insurance coverage. The price is influenced by the type of facility, with hospital-based imaging often being more expensive than dedicated outpatient centers. Many facilities offer discounted rates for patients who choose to pay entirely out-of-pocket.
Insurance coverage is determined by the specific criteria met and the type of insurance plan. Medicare Part B typically covers a bone density test once every 24 months for eligible beneficiaries, including women aged 65 and older and individuals with specific risk factors like hyperparathyroidism or those on long-term steroid therapy. Coverage may be approved more frequently if the patient is being monitored to assess the effectiveness of osteoporosis treatment.
Private insurance companies also cover DEXA scans for osteoporosis screening, but they usually require a physician’s referral and may have their own frequency limitations. Patients are generally responsible for any applicable deductibles, copayments, or coinsurance, which can range from $20 to $100 with coverage. Scans performed for body composition analysis are typically not covered by medical insurance.