Key Points Of The Bone Mass Measurement Act
Health Care Financing Administration (HCFA) regulation that became effective July 1, 1998 and implement provision 186 1 (s)(15) 5) to Section 4106(a)(1) of the BBA to Provide for Uniform Coverage of Bone Mass Measurements.
The law defines “bone mass measurement” as a radiologic, radioisotopic, or other procedure approved by the FDA for the purpose of Identifying bone mass, detecting bone loss, and interpreting bone quality in a “qualified individual.”
Definition of a “Qualified Individual”
- An estrogen deficient women at clinical risk of osteoporosis as determined by a physician or qualified nonphysician practitioner based on her medical history and other findings
- A person with vertebral abnormalities as demonstrated by x-ray to be indicative of osteoporosis, osteopenia, or vertebral fracture
- A person receiving or expecting to receive long-term glucocorticoid (steroid) therapy (equivalent to 7.5mg or greater of prednisone per day for > 3 months)
- A person with primary hyperparathyroidism
- A person being monitored to assess the response to or efficacy of an FDA-approved osteoporosis therapy. Follow-up will be limited to one test every 2 years. Peripheral and central site measurement are acceptable and reimbursable
