Densitometer makers hitch imaging to new CPT code

Buoyed by a new CPT code for vertebral fracture assessment, digital radiography is making fresh inroads into women's health imaging.

Code 76077, established in October by the American Medical Association, covers imaging as a means for assessing the spine for the presence of vertebral fractures. Reimbursement went into effect Jan. 1 specifically for assessment using dual-energy x-ray densitometers.

One of the first companies to benefit from the new code is Hologic, whose Discovery bone densitometer offers an imaging component called instant vertebral assessment as part of its radiologic workup. IVA, introduced as a feature on Discovery in 2003, was upgraded last year to IVA HD (high definition).

IVA HD provides a high-resolution image of the spine in seconds as part of a bone densitometry exam. Image resolution is about double that of images captured using standard IVA.

GE Lunar also offers an imaging feature on its bone desitometers. The technology, called dual-energy vertebral assessment, is built into its Prodigy Advance DXA. The soft-tissue subtraction technique yields high-contrast images of the thoracic and lumbar spine.

"The DXA tool is scientifically preferred to single-energy images for detecting vertebral fractures in patients with osteoporosis," said Jennie Hanson, president of Lunar, a division of GE Healthcare. "Clinicians can identify patients with and without fractures - without requiring patients to hold their breath during an exam."

Hologic's IVA HD is enabled by the company's OnePass fanbeam technology, which has nearly eight times the number of detectors used by competing rectilinear DXA systems and reduces imaging time by more than 800%. The system scans along the anatomy and visualizes the lumbar and thoracic spine well enough to define vertebral deformities.

The updated IVA capability fills an important gap in diagnosis using bone densitometry, according to John Jenkins, Hologic's product manager for the osteoporosis assessment business.

"A traditional bone density measurement will tell you the density of the bone, but it won't tell you if there is a fracture," he said. "You can have a fracture without having a DXA measurement that is osteoporotic."

Typically, patients over 65 with a height loss exceeding 1.5 inches are prime candidates for bone densitometry using radiologic vertebral assessment such as IVA. In Jenkins' opinion, performing IVA on every woman who undergoes densitometry "couldn't hurt."

"It's a standard feature on the machine, there's no film, and there's really no extra cost to provide the procedure," he said. "It only takes a few seconds more to get these extra views."

The technology benefits both patients and physicians, according to Jenkins. Patients receive a more thorough examination, and physicians can diagnose osteoporosis earlier using the latest available technology. Centers that offer the capability are likely to attract patients more easily than those that don't.

Hologic is marketing the technology to hospital radiology departments, clinics, and primary-care physician offices through direct sales and distributors. Jenkins called IVA HD "very important" to Hologic.

"We put a lot of effort into developing a platform that could produce high-resolution images, and we believe it's a necessary component of a bone density study," he said. "We want to offer the best quality exam we can."