CommercialCoverageMedium impact
Bone Densitometry/Bone Density Studies 6.01.05
Excellus BlueCross BlueShield·Radiology, Endocrinology, Rheumatology +3 more·Radiology (x-rays) & Imaging
Effective date
Aug 21, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield updated their bone densitometry policy effective August 21, 2025, establishing specific medical necessity criteria for bone density testing methods including DEXA, QCT, and ultrasound. The policy defines clear age-based and risk factor criteria for women, men, and follow-up testing intervals.
Action Required
By August 21, 2025: Billing team must review and update bone density testing authorization processes to align with new medical necessity criteria. Ensure documentation supports specific age requirements (women 65+, men 70+, or younger patients with defined risk factors) and follow-up testing intervals (every 2-3 years). Update pre-authorization workflows to verify patients meet policy criteria before scheduling DEXA, QCT, or ultrasound bone density studies.