X146 – Bone Mineral Density - two or more sites
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
X146 is a baseline Bone Mineral Density (BMD) measurement by dual-energy X-ray absorptiometry (DXA) for two or more sites. According to the Schedule of Benefits, this service is insured only when the following conditions are met: - The service is rendered for the prevention and management of osteoporosis or osteopenia. - When more than one site is measured, the sites include both hip and spine. Where measurement of both hip and spine is not technically feasible (e.g., due to prosthesis or deformity), the site measured consists of either hip or spine.
When to Use
- Use X146 for the initial baseline BMD scan when the clinical protocol requires assessment of both the hip and spine to manage osteoporosis or osteopenia.
- Use X146 as the baseline measurement when a patient has a deformity or prosthesis that prevents scanning one of the two standard sites, provided the remaining site is still measurable.
Common Pitfalls
- Billing X146 more than once in a patient's lifetime will result in rejection, as patients are strictly limited to a single baseline scan (X145 or X146).
- Submitting X146 for follow-up monitoring is a billing error; subsequent scans must be billed using appropriate follow-up codes like X142 or X148, subject to the 60-month interval rule.
- Claiming X146 when only a single site is measured without documenting the technical infeasibility of the second site may trigger an audit or rejection.
Billing Tips
- Ensure the referral clearly indicates the clinical indication for osteoporosis or osteopenia management to satisfy the mandatory referral requirements for diagnostic radiology services.
- If a patient has previously had a baseline scan (X145 or X146), verify the date of the last scan before billing to ensure the 60-month window for subsequent testing has elapsed.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
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