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AndoverWarMemorialHospital CharltonRoad,AndoverSP103LB Mediating:RHCH01962825013 Fatah:01264351424 BONE DENSITOMETRY (DA) REQUEST FORM If hospital referral, please state name of consultant, specialty

How to fill out bone densitometry dxa request

How to fill out a bone densitometry DXA request:

1. Gather patient information: Collect the patient's full name, date of birth, contact information, and relevant medical history.
2. Indicate the referring physician: Include the name and contact details of the physician who is requesting the bone densitometry DXA test.
3. Specify the reason for the request: Clearly state the purpose of the bone densitometry DXA test, such as to assess bone density, diagnose osteoporosis, or monitor treatment effectiveness.
4. Provide relevant clinical information: Include any relevant medical conditions or symptoms that may assist in interpreting the DXA results. This could include a history of fractures, prolonged steroid use, or chronic medical conditions impacting bone health.
5. Include insurance and billing information: If applicable, provide the patient's insurance details, including policy number, group number, and any specific requirements for authorization or pre-approval.
6. Indicate any special requirements: If there are any specific instructions or requests for the test, such as the use of contrast dye or specific imaging protocols, make sure to note them on the request form.
7. Sign and date the request form: Ensure that the referring physician signs and dates the bone densitometry DXA request, indicating their authorization and agreement to the test.

Who needs a bone densitometry DXA request:

1. Individuals at risk for osteoporosis: Postmenopausal women and men aged 50 and older are often recommended to undergo bone densitometry DXA testing to assess their bone health.
2. People with risk factors for low bone density: Individuals with a family history of osteoporosis, a personal history of fractures, prolonged use of certain medications (such as corticosteroids), or medical conditions that may affect bone density (such as hyperparathyroidism) may require a bone densitometry DXA request.
3. Monitoring treatment effectiveness: Patients who are undergoing treatment for osteoporosis or other bone-related conditions may need regular bone densitometry DXA tests to monitor the effectiveness of the treatment and make adjustments as necessary.
4. Assessing fracture risk: In certain cases, physicians may request a bone densitometry DXA test to evaluate an individual's risk of fractures due to low bone density or osteoporosis, especially if there is a concern or suspicion of reduced bone strength.

Note: The necessity of a bone densitometry DXA request may vary depending on individual circumstances, and it is best to consult with a healthcare professional to determine if the test is appropriate for a particular patient.

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What is bone densitometry dxa request?

Bone densitometry DXA request is a medical procedure used to measure bone density and diagnose conditions like osteoporosis.

Who is required to file bone densitometry dxa request?

Healthcare providers, such as doctors or specialists, typically file bone densitometry DXA requests for their patients.

How to fill out bone densitometry dxa request?

To fill out a bone densitometry DXA request, healthcare providers need to provide patient information, reasons for the test, and any relevant medical history.

What is the purpose of bone densitometry dxa request?

The purpose of a bone densitometry DXA request is to assess bone density, identify osteoporosis, and evaluate the risk of fractures.

What information must be reported on bone densitometry dxa request?

Patient demographics, medical history, reason for the test, and any relevant medications must be reported on a bone densitometry DXA request.