Which of the following situations prevents Medicare from covering a DXA scan?

• A. When the patient is over the age of 65
• B. Patients on glucocorticoid therapy for more than 3 months
• C. If the patient is pregnant
• D. Patients with diabetes

Answer: (B)

Medicare coverage for DXA (dual-energy X-ray absorptiometry) scans is typically conditioned on clinical indications and specific patient circumstances. In this instance, the situation where a patient is pregnant is a recognized limitation for coverage because of the potential risks associated with radiation exposure to the fetus. Even though DXA scans utilize low doses of radiation, it is generally recommended to avoid unnecessary imaging in pregnant patients unless absolutely necessary.

Conversely, patients over the age of 65, those on long-term glucocorticoid therapy, and patients with diabetes may have specific criteria under which DXA scans are typically covered, including the screening and diagnosis of osteoporosis. While glucocorticoid therapy is indeed a factor in osteoporosis risk and Medicare would expect those patients to receive DXA scans, pregnancy specifically precludes the procedure due to safety concerns.

Thus, understanding the unique considerations that relate to pregnancy helps clarify why this scenario would prevent Medicare from covering a DXA scan.