The National Electrical Manufacturers Association (NEMA) through its Medical Imaging & Technology Alliance (MITA) published XR-29 Standard Attributes on Computed Tomography Equipment Related to Dose Optimization and Management.
A federal provision signed into law in April 2014 requires health care providers to comply with the NEMA Standard XR-29 for improved computed tomography (CT) radiation safety.
XR-29 also known as MITA Smart Dose,
includes four key features of CT equipment that enable optimization or management of radiation dose delivery while also providing high quality medical images. These four key features arDICOM-compliant radiation dose structured reporting, dose check features, automatic exposure control and reference adult and pediatric protocols.
What are the 4 key features NEMA XR-29/MITA Smart Dose Standard
A feature that enables recording of post exam dose information in a standardized electronic format. The information can be included in the patient record, promoting the establishment of diagnostic reference levels, as well as facility dose management and quality assurance.
A feature that incorporates both dose notifications and dose alerts, which warn operators and physicians when dose exceeds established safety thresholds.
A feature that automatically adjust the amount of radiation within prescribed bounds as needed, in order to to attain the desired image quality. If user adequately it may result in dose reductions.
A feature that includes a set of pre-loaded parameters on a CT scanner for pediatric and adult use that can be selected by the operator to complete a particular clinical task, such as capturing an image of the abdomen.
What are the penalties for XR-29 non-compliance?
After January 1, 2016 all CT equipment not in compliance with the requirements of the XR-29 standard became be subject to a 5 percent per scan technical component reduction on diagnostic CT procedures billed in physician office and hospital outpatient settings. The reduction will increase to 15 percent Jan. 1, 2017.
How do penalties lower my reimbursements?
As a rule all scanners not in compliance with all four attributes of the XR-29 Standard became subject to a 5% per scan reduction on January 1, 2016. This reduction will increase to 15 percent January 1, 2017. As an example, HCPCS code 70488 which was reimbursed at $302.70 per scan for 2015 has now been cut to $287.56. If your CT scanner has not been upgraded to meet the XR-29 requirements, starting in 2017 the reimbursement rate would be $257.29. If you have a slightly significant volume this reduction in reimbursements may severely affect your bottom line. But this loss can be avoided by upgrading your scanner in a efficient and cost effective manner.