Realizing that height loss is a code for DXA reimbursement, we designed a QA study, aimed at closing the male ‘DXA screen’ care gap. METHODS: We met with our ‘caregap’ team and designed our QA analysis. Importantly, we received selleck kinase inhibitor approval from Epigenetics inhibitor Primary Care Service Line Leadership. An analyst had access to 14,666 patient charts who had multiple clinic visits, but never had a DXA. From this group, 6147 patients had documented height loss, of which 2045
lost >1.5 in. and were age 70 or older. We followed this process: Patients would be sent a letter, informing them of the reason for DXA, with the approval and consent of their primary care physicians (PCP). The team sent letters and then called those who did not respond. They arranged for a pended DXA order to be sent to PCP via EHR. In total, 751 patients were identified and had a DXA order placed after 1/1/2012. DXA order status showed 130 completed DXA’s; 446 ordered but not scheduled; 166 ordered but cancelled by PCP; and 9 ‘other’. DXA’s were classified with NOF and ACR GIOP guidelines. A patient was High-Risk based on : 1) fragility fracture of spine or hip; 2) T-score < or = −2.5 in post-menopausal woman or man >50 years old; 3) FRAX major osteoporosis fracture risk of 20 % and/or hip fracture
risk of 3 % or more; and 4) ACR GIOP guidelines. We report the data on 130 men > age 70 with 1.5 in. or more documented height loss who had a completed DXA in EHR. RESULTS: 128/130 DXA scans were evaluable. Patients ranged from 70 to 97 years old (mean age 78.6 +/− 5.7 SD). Two DXA reports were unevaluable. Of these patients, 56/130 mTOR target (43 %) men were High-Risk by DXA. Of these 56 High-Risk men, 10 (18 %) were High-Risk based on hip or spine fracture; 22 (39 %) based on FRAX; 24 (43 %) based on T-score. Within this high-risk group, 11 patients (20 %) reported a history of fracture on DXA questionnaire. CONCLUSIONS: Our study documents 43 % of those MycoClean Mycoplasma Removal Kit men 70 and older with 1.5 in. or more of documented height loss who had DXA’s were High-Risk. Our study reinforces the clinical application of FRAX as 39 % of our High-Risk population was classified by FRAX. Importantly, the new payment rate for DXA
dropped on 1/1/2013 from a national average of $56 to $50. The 2007 ISCD Official Positions support DXA in men over age 70. Yet, there is no reimbursement code. Thus, a continued care gap in male osteoporosis care exists. The process we used can be modeled by many USA health care systems and others abroad. Our study supports efforts to adopt a screening reimbursement code for men over age 70 and may stimulate others to use height loss to identify men at risk for osteoporosis complications. P3 THE ASSESSMENT OF LOW DENSITY HIP SCANS IN SUBJECTS WITH HIGHER FAT SOFT TISSUE CONTENT Chad A. Dudzek, BS, Norland — a CooperSurgical Company, Fort Atkinson, WI; Jing M. Wang, RN, Norland — a CooperSurgical Company, Beijing, China; Felix Rajan, BS, MBA, Siemens Healthcare, Malvern, PA; Kathy M.