Radiology Coding Alert

Osteopenia and osteoporosis are not the same. “Osteopenia is seen in patients over 50 years. The average bone density average is low for the patient’s age but not severely low and can be reversed with supplements, where osteoporosis is more severe and needs treatment with drugs, says Dianne Nakvosas, ACS-RAD, Compubill, Inc., IL.

Osteopenia: Osteopenia is a condition of low bone density and is an early sign of bone loss. It is a precursor to osteoporosis.

Osteoporosis: Osteoporosis is a condition of reduced bone mass and change in structural integration of the bone. According to World Health Organization (WHO) criteria, patients with osteoporosis have a dual-energy x-ray absorptiometry (DXA) T-score of less than -2.5 SD (standard deviation). Osteoporosis implies fragile bones and the risk of fractures is high in patients with osteoporosis. Osteoporosis commonly occurs in women after menopause and estrogen deficiency leads to the development of weak bones. Fractures of the hip, spine, and wrist are common in women with osteoporosis.

Diagnosis: Both osteopenia and osteoporosis are silent and chronic conditions. Your provider will typically order for a DXA to measure bone mineral density that will help to assess osteopenia or osteoporosis. If the T-score from the DXA is -1 to -2.5 SD, it is indicative of osteopenia, and a score less than -2.5 SD is indicative of osteoporosis. If the patient is also suffering from fractures, a score less than -2.5 SD is indicative of severe osteoporosis.

Why screen for osteopenia and osteoporosis? Both osteopenia and osteoporosis can occur even in patients who have no risk or few risk factors for the conditions. In most cases, both the conditions remain without any symptoms until there is a fracture that occurs spontaneously or with a minor fall (or trauma). As the condition progresses silently, it is essential to screen patients for these conditions.