Company Workflow

This section is intended to provide guidance to healthcare Facilities
on the following topics:

  1. Company Requirements for DXA use
  2. DXA Operator Requirements
  3. The Referral Process
  4. DXA Scan Acquisition
  5. The Reporting Process
  6. Medicare Benefits
  7. Private Health Insurance Rebates
Company Requirements for DXA use:

Although each state will have varying requirements, at the absolute least each premises operating a DXA device will require:

  1. Radiation Safety Plan
  2. Site Compliance Testing (forms a part of the Radiation Safety Plan)
  3. License to Possess to apparatus
  4. Licensed and trained operators*

*Licensing can either be covered through an approved radiography association (radiographers) or an approved DXA licensing course (other allied health professionals) which Hologic can provide.

DXA Operator Requirements:

Each DXA operator will need to be officially licensed to operate the device which can be covered by 2 streams:

1. Being a qualified radiographer holding a membership with a recognized association (eg: The Australian Institute of Radiography)

2.Having completed an approved DXA licensing course* which in most cases has the prerequisite of holding a relevant degree level allied health qualification.

*Hologic have an in house DXA licensing course specializing in their own branded devices. Please contact us for details.

In addition to licensing, all Hologic DXA operators are required to undergo device specific applications training which can either be provided by Hologic or an appointed super user who has been trained by Hologic.

The Referral Process:

To comply with ARPANSA (Australian Radiation & Nuclear Safety Agency) medical radiation guidelines, all medical uses of radiation require a written referral from a medical practitioner to justify an exposure, put officially:

(a) generically or on an individual basis by the radiological medical practitioner, depending on the nature of the procedure and the patient, or

(b) generically by an acknowledged professional college or authority.

This also applies to BMD scans which may qualify for Medicare Rebates.

DXA Scan Acquisition:
  1. BMD scanning will need to pay particular attention to the referral’s request, official recommendations from associative bodies* and manufacturer scanning guidelines. The overall aim is to ensure only required sites are scanned, regions of interest are emphasized appropriately and scans are acquired in a fashion which can be adequately reproduced in serial instances for maximized precision.

* eg: ISCD (International Society for Clinical Densitometry), ANZBMS (Australian & New Zealand Bone Mineral Society)

  1. BCA scanning should pay equal attention to the referrer’s request and official associative recommendations. In any case follow the manufacturer’s guidelines to ensure reporting is as accurate and appropriate as possible.
The Reporting Process:
  1. BMD Scan reporting requires analyzed results to be evaluated by a licensed radiologist and passed on to the initial referrer (most often a GP) for patient consultation. This is a particularly important process for BMD results as they are intended for medical diagnostics.
  2. BCA Scan reporting can be performed by an adequately trained professional or sent alongside a BMD scan through the same radiologist/referrer process shown above.
  3. In either case the reporting professionals will need a clear understanding of:
    – Whether the scans have been analyzed correctly
    – Details of all associated population reference data being used
    – Appropriate interventions in response to diagnostic and non-diagnostic results

Medicare Benefits:

Currently Medicare only cover BMD scanning with relation to obtaining rebates as per the following item numbers (From Nov 2017):

MBS ITEM DESCRIPTION
12320 Patient >70, no previous BMD
12320*** Patient >70, previous T-Score >-1.5
12322** Patient >70, previous T-Score between -1.5 & -2.5
12306** 1 or more fractures due to minimal trauma
Previously diagnosed osteoporosis (T-Score <-2.5)
12312* Prolonged glucocorticoid therapy
Cushing’s Syndrome
Menopause before 45
Male Hypogonadism
12315** Hyperthyroidism/Hyperparathyroidism
Chronic Liver disease
Malabsorption Disorder
Chronic Renal disease
Rheumatoid Arthritis
12321* Monitor change in osteoporosis therapy after 1 year of treatment
12300 No rebate (patient does not meet any criteria)

* 1 rebate per 12 months; ** 1 rebate per 2 years; *** 1 rebate per 5 years

 

Case Study coming soon