BMD testing - rebate

The following Medicare item numbers are available for diagnosis and monitoring of osteoporosis.

Item 12323

• Males or females aged 70yrs or over

Item 12306

• Presumed diagnosis of osteoporosis (1 or more fractures occurring after minimal trauma)
• Monitoring of low BMD (proven by previous bone densitometry at least 12 months ago)

Item 12312

• Prolonged glucocorticoid therapy
• Conditions associated with excess glucocorticoid secretion
• Male hypogonadism
• Female hypogonadism lasting > 6 months and is < age 45

Item 12315

• Primary hyperparathyroidism
• Chronic liver disease
• Chronic renal disease
• Proven malabsorption
• Conditions associated with thyroxine excess
• Rheumatoid arthritis

Item 12321

• Monitor BMD following a significant change in therapy (after 1 year of treatment)

Medications for prevention of fractures available on the PBS

Men and women aged 70 years and over with a BMD T-score of ≤ -3.0 can receive treatment for osteoporosis on the PBS without having sustained a fracture, ie. for primary prevention.

The following medications are listed for primary prevention:

• Alendronate (Fosamax, Fosamax Plus, Alendro, Adronat, Alendrobell, Alendronate[various generic brands], and Ossmax)
• Risedronate (Actonel, Actonel once-a-week, Actonel once-a-month, Actonel Combi, Actonel Combi D)
• Strontium ranelate (Protos) (women only)
• Zoledronic Acid (Aclasta) (women only) - Only 1 treatment each year for 3 years per patient in a lifetime will be PBS subsidized.

The PBS also subsidises treatment for osteoporosis in patients of any age who have had a minimal-trauma fracture:

• Alendronate
• Risedronate
• Etidronate (Didrocal)

The following are subsidized for treatment of osteoporosis in post-menopausal women who have had minimal trauma fracture:

• Raloxifene (Evista)
• Strontium ranelate (Protos)
• Zoledronic Acid (Aclasta)

The following is subsidized for men with osteoporosis who have had a minimal trauma hip fracture:

• Zoledronic Acid (Aclasta) - Only 1 treatment each year for 3 years per patient in a lifetime will be PBS subsidized

The following is subsidized for the prevention of corticosteroid-induced osteoporosis in men and women currently on long term (3 months or more) , high dose(> 7.5mg/day prednisolone or equivalent) corticosteroid therapy, with bone density T score < -1.5:

• Risedronate (Actonel)