Vertebral assessment CPT code promises to boost BMD sales

The American Medical Association has approved a Current Procedural Terminology (CPT) code for use of dual energy x-ray absorptiometry (DXA) to perform spinal imaging as a means for assessing the presence of vertebral fractures in osteoporosis patients. Guidelines for implementing the CPT code are still being worked out. Reimbursement is still further away. But the development of the code, the end result of some five years of lobbying by proponents of bone mineral densitometry, is a critical first step.

The code, which is published in the 2005 edition of the AMA's Current Procedural Terminology, is largely the result of efforts by the International Society for Clinical Densitometry and similar organizations, according to Brad Herrington, vice president and business unit manager for Hologic's osteoporosis and fluoroscan division. The densitometer market is likely to enjoy a boost as a result of the new code, although the primary beneficiary will be women with osteoporosis.

"This recognizes that many women with fractures are undiagnosed and that they have a much higher chance of sustaining subsequent fractures," Herrington said. "A woman with a vertebral fracture has been shown to have roughly a 20% chance of refracturing within the next year."

Approval of the code marks a step forward from single- and dual-view x-ray codes covering radiography of the lateral spine. The new code is specific in that it designates the performance of imaging using a DXA machine, such as Hologic's Instant Vertebral Assessment (IVA) densitometer. GE Lunar also has technology - the GE Lunar Prodigy - that fits the new code, said Jennie Hanson, vice president and general manager of GE Healthcare's bone densitometry business.

According to Herrington, the IVA incorporates a fanbeam design that enables completion of a lateral spine exam in only seconds. The design also permits the detection of finer fractures, he said.

The new code could give all makers of bone densitometers a boost, providing they have densitometers that use fanbeam technology. At the moment, Hologic is one of the few, according to Herrington.

"From a competitive point of view, it highlights the advantage we have utilizing a single-pass fanbeam over a rectilinear design," he said. "It'll expand the upgrade market. It also provides at least some economic incentive for physicians to perform this imaging exam on women who qualify."

While suggesting the code gives Hologic a leg up on its competition, Herrington said the most important implication is the benefit afforded women. Last year, Hologic announced a heightened focus on women's health.

"The most important thing is that more women who deserve treatment will be assessed correctly," he said.

While not predicting an effect on Hologic's bottom line, Herrington expects the company to ramp up production of the IVA. He also believes an upgraded product may result from the AMA's decision to establish the CPT code.

About 70% of Hologic's densitometers have vertebral assessment capabilities. This percentage could increase as a result of the new code. Company engineers are also trying to improve vertebral assessment.

"Our focus in the future will be on creating tools and workflow that make (imaging for fractures and assessment of physicians) faster and easier to perform," he said. "Time will tell, but (the introduction of an upgraded IVA) is likely to happen. We have a platform that is easily upgradable."