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Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)

CPT4 code

Name of the Procedure:

Vertebral Fracture Assessment via Dual-Energy X-ray Absorptiometry (DXA)

Summary

Vertebral Fracture Assessment (VFA) using Dual-Energy X-ray Absorptiometry (DXA) is a non-invasive imaging technique to detect fractures in the vertebrae. It involves using low-dose X-rays to create detailed images of the spine, which help in identifying any existing fractures that may not be evident through physical examination or less advanced imaging tests.

Purpose

The procedure is primarily used to diagnose vertebral fractures, which may result from osteoporosis or other conditions that weaken the bones. Early detection through this assessment can prevent further fractures and guide appropriate treatment to strengthen the bones and improve the patient's quality of life.

Indications

  • Patients with suspected osteoporosis or low bone density.
  • Individuals with unexplained back pain.
  • Elderly patients at risk of fractures due to age-related bone loss.
  • Patients with a history of fractures or those on long-term steroid therapy.

Preparation

  • Usually, no special preparation is required.
  • Patients should inform their doctor of any recent barium examinations or injections of contrast material for a CT scan or radioisotope scan.
  • Wearing loose, comfortable clothing and avoiding metal buttons or zippers in the area to be scanned is recommended.

Procedure Description

  1. The patient lies on a cushioned table, and the DXA machine scans the spine.
  2. The machine emits low-dose X-rays from two different sources, and the detector measures the amount of each X-ray that passes through the spine.
  3. The data is processed to create detailed images of the vertebrae.
  4. The technologist ensures the patient remains still during the scan to obtain clear images.
  5. The procedure is usually painless and does not require any sedation or anesthesia.

Duration

The procedure typically takes about 10-30 minutes.

Setting

This procedure is performed in a hospital radiology department, outpatient clinic, or specialized imaging center.

Personnel

  • Radiologist or trained technologist to operate the DXA machine and interpret results.

Risks and Complications

  • Exposure to low levels of radiation, though it is minimal and generally considered safe.
  • Rarely, a patient may have an allergic reaction to the contrast material if used.

Benefits

  • Early detection of vertebral fractures can prevent further damage.
  • Non-invasive, quick, and painless procedure.
  • Helps in tailoring appropriate treatment plans to manage osteoporosis or other bone conditions.

Recovery

  • No specific recovery time; patients can return to normal activities immediately.
  • Follow-up appointments may be scheduled to discuss results and ongoing treatment plans.

Alternatives

  • Conventional X-ray: Less sensitive for subtle fractures.
  • MRI: More detailed but more expensive and time-consuming.
  • CT Scan: Offers detailed images but involves higher radiation exposure.

    Each alternative has its pros and cons, with DXA offering a balance between detail, safety, and convenience.

Patient Experience

  • Patients typically feel comfortable and relaxed during the procedure.
  • Most experience no pain or discomfort, and there is no need for recovery time.
  • The process is simple and allows patients to resume their daily activities immediately after completion.

Medical Policies and Guidelines for Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA)

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