Bone Density

The Minnesota Department of Health (MDH) is seeing many bone densitometry units (Bone Mineral Densitometry or BMD) being installed in facilities. Some of these facilities do not have other x-ray equipment and consequently are not aware of the regulations regarding them. If the BMD unit emits ionizing radiation, Minnesota Rules, Chapter 4732.0850 applies.

This means:

• The unit must be registered by the facility with the Minnesota Department of Health, Radiation Control Unit.
• The facility must abide by all applicable rules in Chapter 4732. Failure to do so could result in monetary fines.
• A qualified radiation safety officer must be assigned to oversee the safety and training of operators and the safety of patients.
• All BMD tests must be ordered by a licensed practitioner of the healing arts (i.e., medical doctor, dentist, chiropractor, podiatrist, certified nurse practitioner, or a physician's assistant with a valid delegation agreement). If a screening project is planned where no doctor's order would be required, the Commissioner of Health must approve it in advance. (See 4732.0565 Healing Arts Screening)
• The BMD unit can only be operated by people who have passed an exam approved by the Commissioner of Health to operate ionizing radiation producing machines.
• "Precision testing," whereby the operator is to repeat the exam on the same patient is considered training or testing on patients and is prohibited.

Precision testing protocol

The Minnesota Department of Health, Ionizing Radiation Rules, Chapter 4732.0560, states that a radiographic procedure must be ordered by a licensed practitioner of the healing arts; must include the clinical indications for the examination; and must be available to the procedure personnel at the time of the examination. In addition, 4732.0305 prohibits exposing an individual to the useful beam except for healing arts purposes.

MDH continues to review available information related to precision testing protocols. At this time, facilities wishing to utilize this procedure must follow Chapter 4732.0560.

NOTE:  4732.0305 only allows for a licensed practitioner of the healing arts to order the precision testing. This does not include PA’s, Advanced Practice Nurses or any other qualified under 4732.0560.