Bone Mass Measurements (CPB 0134, reviewed 2026-03-19)
Effective date
Not stated in the notice
Identified
Aug 19, 2026
Summary
Aetna considers bone mass measurement medically necessary when a member meets one of the listed criteria, such as long-term glucocorticoid therapy of 5 mg prednisone or more per day for more than 3 months, long-term anticonvulsant therapy, long-term aromatase inhibitor therapy, or non-traumatic (fragility) fractures. Repeat bone mass measurements are usually not indicated more frequently than once every 2 years, except in the circumstances the policy lists. Bone mass measurement by dual photon absorptiometry, dual X-ray and laser, single photon absorptiometry, pulse-echo ultrasound, cone beam CT, deep learning-based quantitative CT, finite element analysis, skin autofluorescence for AGEs, radiofrequency echographic multi spectrometry and urinary phthalate testing is considered experimental, investigational or unproven.
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01Billing team: Before billing bone mass measurement, confirm the member meets one of the policy's selection criteria, such as long-term glucocorticoid therapy of 5 mg prednisone or more per day for more than 3 months or long-term anticonvulsant therapy.
02For monitoring osteoporosis drug therapy, use only dual-energy x-ray absorptiometry (DXA), because the policy covers only DXA for that indication.
03Repeat bone mass measurements are usually not indicated more frequently than once every 2 years, except in the circumstances the policy lists.
04Screening of men greater than 70 years of age and screening of estrogen-deficient women are covered only for members with preventive services benefits.
05Do not bill CPT 78350 or 78351, or the experimental techniques listed in the policy such as dual photon absorptiometry, dual X-ray and laser, single photon absorptiometry and pulse-echo ultrasound, for the indications the policy does not cover.
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