Medicare Rebate

12306 (one test every 24 months)

  1. Broken bones or fractures in last ten years, caused by minimal trauma OR

  2. Monitoring proven low bone density (Osteoporosis) from previous DEXA or CT scan with a T score of -2.5 or less.                     

Explanation: 1 or more fractures occurring after a minimal trauma; or Monitoring of low bone mineral density (OSTEOPOROSIS) proven by bone densitometry scan (falls more than 2.5 standard deviations below the young normal mean at the same site and in the same gender)

12312 (one test every 12 months)

  1. -       Began menopause or had complete hysterectomy before the age of 45 years OR

  2. -      Currently taking Prednisolone or corticosteroid treatments and have done so for >4months OR

  3. -       Low testosterone in males

Explanation:

Prolonged glucocorticoid therapy; conditions associated with excess glucocorticoid secretion (defined as thecommencement of a dosage of inhaled glucocorticoid equivalent to or great than 800micrograms beclomethasone dipropionate or budesonide p/day or a supraphysiological glucocorticoid dosage equivalent to or greater than 7.5mg prednisolone in an adult taken orally per day for a period anticipated to last at least 4 months) or; 

Male Hypogonadism or Female Hypogonadism lasting more than 6 months before the age of 45 (defined as serum testosterone or serum oestrogen levels below the age matched normal range)

12315 (one test every 24 months)

  1. Patients diagnosed with rheumatoid arthritis, chronic liver or kidney disease, hepatitis, Crohn’s,Coeliac, Graves, Hashimoto’s, malabsorptive disorders or an overactive thyroid.

Explanation: Primary hyperparathyroidism, chronic liver disease, chronic renal disease, proven malabsorptive disorders, rheumatoid arthritis, or conditions associated with thyroxine excess (malabsorptive defined as one or more of the following: malabsorption of fat, defined as faecal fate estimated at greater than 18mg per 72 hours on a normal fat diet, or bowel disease with presumptive vitamin D malabsorption as indicated by a sub-normal circulating 25-hydroxyvitamin D level or histological proven Coeliac disease).

12321 (one test every 12 months)

  1. Have been diagnosed with osteoporosis (via DEXA or CT scan) and have had significant change of treatment (ie; started treatment or had a change in class of drugs, ie moved from Fosamax to Prolia ).

Explanation: Intended to allow for bone mineral density measurement following a significant change n therapy – e.g. a change in the class of drugs - rather than for a change in the dosage regimen.

12320 (one test every 5 years )

  1. Patient is 70 years or older and not previously had a BMD examination ( initial scan ) ;
  2. Patient has a T- Score from a previous BMD of -1.5 and above.

12322 (one test every 24 months)

Claimable if patient is aged 70 or older and has a T- Score from previous BMD between -1.5 and -2.4.

MBS guidelines for DEXA referrals require the GP to tick the appropriate Medicare item number that the patient qualifies under for the scan. It will also requires the GP tick the appropriate Medicare descriptor associated with this item number..