OHIP : Bone Mineral Density

Osteoporosis is a disease characterized by low bone mass leading to fragile bones and increased risk of fractures.  Bone mineral density (BMD) testing assesses bone loss due to osteoporosis and helps the patient and physician to measure the risk of future fractures, determine the need for medical treatment and to monitor the success of existing treatment.

Medical experts recommend that BMD testing be carried out using only the ‘axial DXA’ machine which scans both hip and spine.  This technique is clinically superior to all other testing methods and is the only method insured by OHIP.

OHIP covers annual BMD tests in persons at high risk for osteoporosis and future fractures.  The 2002 Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis in Canada can be found at : www.cmaj.ca/cgi/reprint/167/10_suppl/s1.pdf .

Effective April 1, 2008, low risk patients are eligible for BMD testing once in any 36-month period.  For services on or after April 1, 2008, this 36-month period will be determined from April 1, 2005 onwards.

Low risk patients and referring physicians need to advise diagnostic facilities of the date of any previous
BMD test so that the facility can verify that the planned test is insured.  The Interactive Voice Response (IVR) system may also be used to determine the date of a previous BMD test.  Instructions on the use of IVR can be found at www.health.gov.on.ca/english/providers/pub/ohip/inter_voiceresp/inter_voiceresp_mn.html.

What is not covered?

BMD testing of low risk persons provided more frequently than once every 36 months is uninsured but may be provided at the patient’s expense.

 Why?

Current recommendations by the Ontario Health Technology Advisory Committee (OHTAC) do not support the need for low risk patients to be tested more often than every three years. The changes in OHIP coverage reflect these recommendations. High risk patients (determined by the physician) will continue to receive annual access.

 For More Information:

This fact sheet includes material provided by the Osteoporosis Society of Canada (OSC).  Further information on osteoporosis may be obtained from the OSC’s website.
Patients should discuss their individual health needs with their family physician.

April 2008