Currently, the standard for assessing bone mass is dual energy x-ray absorbtsiometrii or DEXA. Measurement of bone mass of lumbar spine and hip are now being used for purposes of diagnosis and treatment monitoring. Peripheral areas, such as brushes and five may be useful screening tools in elderly people, but an imbalance between bone sites rate of loss with age. So again many postmenopausal women will have normal bone mass of five, and still have a clinically significant decrease in bone mass in the spine. FDA recently approved ultrasound techniques to use as a screening test for low bone mass. Currently, different manufacturers of bone densitometers all use different reference populations from which standard deviations were calculated from the norm, also called T points. There are differences in calibration between the companies as well, so that individual patients' bone density readings can differ by as much as 12% from one machine to another. Thus, to monitor the patients response to treatment as bone densitometer should be used. It is a challenge when patients are often referred to centers based insurance. While the T score is used to assess bone mass, diagnose osteoporosis and predict fracture risk, due to Z, or in comparison with the corresponding age people use to determine whether bone mass of patients unexpectedly low. Bill Z -2. 0 or more negative is often used to determine whether the larger laboratory evaluation is conducted to evaluate secondary causes of bone loss, such as myeloma, vitamin D deficiency and hyperparathyroidism. Investigation of bone density provides information about current patients bone mass, but not to assess whether the bone loss is accelerated. Blood and urine studies were designed to evaluate the bone. Most of these markers are degradation products of proteins specific to bone, including n-telopeptydu (NTX or Osteomark), C-telopeptydu (CTX) and Dezoksypirydynolin stitching (Pyrilinks-D). Proper use of these markers in clinical practice is controversial. There is evidence to show that they involve the loss of bone mass assessment of bone densitometry than one year to two years.
Small studies show the use to monitor response to treatment such as bisphosphonates and estrogen. The study is repeated three months after treatment a clinical response is evaluated in three months. Variablity measurements is estimated at 20% cost reduction of 30% is considered a response to treatment. On October 1, 1999, Medicare will provide reimbursement of order lasix biomarkers for monitoring bone loss while spending approximately 30 percent of the study. Medicare
Guidelines for bone densitometry became effective on 7/1/98. Patients
must match one of the following criteria: >> << spinal disorders, as shown by X-ray to be a sign of osteoporosis, osteopenia
or fractures of the spine. Chronic glucocorticoid use, defined as 7. 5 mg / day or more of prednisolone or equivalent steroids for 3 months or more, or intended use of such therapy. Individual >> << under control, to assess response, or effectiveness, FDA approved osteoporosis drug therapy. ** Medicare covers bone mass measurement beneficiary every two years. Most ** central bone densitometry will be covered with medical necessity, if, for example, using steroids, or to confirm the results of screening, such as ultrasound or peripheral densitometry bone. National Osteoporosis Foundation ** also suggests that bone densitometry is appropriate in a positive family history of osteoporosis, chronic use of thyroxine, growth loss, vertebral deformities without X-ray evidence, and any cracks for which the degree of injury is inadequate degree of damage. Medicare reimbursement of central bone densitometry is about 140; and peripheral ultrasound, reimbursed at 50. It is now possible for patients to peripheral densitometry in places such as pharmacies and health fairs. Again, because bone mass at peripheral sites varies slowly over time, and there are differences in bone mass of different anatomical regions of normal peripheral measurement of bone mass in patients with significant risk factors for osteoporosis should be tested to measure bone mass and spinal hip. Peripheral technology of ultrasound are accurate, but there are enough data to access accuracy over time. Thus, they are not currently used to monitor response to treatment, although this recommendation may change with more data. Located below the six questionnaires Test Questions for the treatment of osteoporosis,
SCORE (S imple C alculated About steoporosis R claims stimation E). SCORE has been shown that in 89% sensitivity and specificity of 50% in patient population in postmenopausal women. The questionnaire below can be used by employees of the office support to identify persons for whom bone densitometry is warranted to confirm the clinical signs of osteoporosis. If your final score greater than or equal to 6, you may be at risk for osteoporosis. Talk to your doctor about further evaluation. .
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