[Reimbursement. Case report: Medical implication as precondition for reimbursement by German health insurance on the example of HRpQCT diagnosis of osteoporosis]. / Reimbursement um jeden Preis? Erstattungsfähigkeit einer Untersuchungsmethode aus versicherungsrechtlicher Sicht am Beispiel HRpQCT-Diagnostik bei Osteoporose.

The main condition that has to be met for reimbursement is the medical implication of the chosen method. This issue is discussed based on the case of a 72-year-old patient suffering from osteoporotic fractures of the spine. Drug treatment of osteoporosis was observed with a high-resolution peripheral CT (HR-pQCT/XtremeCT). A German court came to the conclusion that there is no added value of the procedure in comparison with the well-established DXA. Judges rejected the need for reimbursement in that particular case and ruled in favor of the insurance company, which had originally refused the refund.