X153 – Bone Mineral Density (BMD) Measurement - Second Test - Low Risk Patient - Two or More Sites
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
This is a second Bone Mineral Density (BMD) measurement by Dual-energy X-ray Absorptiometry (DXA) of two or more sites, which must include both hip and spine unless technically not feasible. It is indicated for a 'low risk patient' for the prevention and management of osteoporosis or osteopenia. A 'low risk patient' is defined as a patient who is not at high risk for accelerated bone loss, does not have previously diagnosed osteopenia or osteoporosis, and has not shown bone loss greater than 1% per year on previous tests. If measurement of both hip and spine is not technically feasible due to prosthesis or deformity, measurement of either hip or spine is acceptable.
When to Use
- Use for a follow-up BMD in a patient who has maintained stable bone density and does not meet the criteria for high-risk monitoring (i.e., no osteopenia/osteoporosis diagnosis and no rapid bone loss).
- Use when the patient requires a second or subsequent scan after their baseline (X145/X146) and they remain classified as 'low risk' under the OHIP definition.
Common Pitfalls
- Billing X153 for a patient with a prior diagnosis of osteopenia or osteoporosis, which automatically disqualifies them as 'low risk' and necessitates a different code.
- Submitting for payment within 60 months of the previous scan, which will trigger an automatic rejection as the service is not eligible for payment before this interval.
- Failing to include both hip and spine measurements without documenting the specific technical infeasibility (e.g., severe deformity or prosthesis) that prevented the dual-site scan.
Billing Tips
- Ensure the patient's clinical history confirms they have not shown bone loss exceeding 1% per year on previous tests, as this is a strict requirement for the 'low risk' designation.
- Always verify the date of the previous BMD scan to ensure the 60-month eligibility window has elapsed before submitting X153.
Effective: April 1, 2005
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
Measurement of hip and spine would be considered not technically feasible due to prosthesis or deformity.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.