XR29 Standard and How It Will Affect CT Billing and Reimbursement

19th May 2016

The National Electrical Manufacturers Association’s Medical Imaging & Technology Alliance (MITA) has published XR 29 Standard Attributes on Computed Tomography (CT) Equipment Related to Dose Optimization and Management. 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.

“MITA continues its dose reduction efforts with the approval of MITA Smart Dose, a standard that offers healthcare providers an additional tool to optimize and manage dose in CT scanning,” said Gail Rodriguez, executive director of MITA. “We look forward to working with our industry partners to promote the adoption of MITA Smart Dose, and increase patient access to these technologies.”

Several attributes of CT equipment help physicians and technologists optimize and manage dose. The MITA Smart Dose standard bundles four of these important features to ensure that compliant equipment produces high-quality diagnostic images while supporting patient safety. They are:

  • DICOM (Digital Imaging and Communications in Medicine) Radiation Dose Structured Report, which enables recording of post-exam dose information in a standardized electronic format. This information can be included in the patient record, promoting the establishment of diagnostic reference levels, as well as facility dose management and quality assurance.
  • CT Dose Check, which incorporates two features—dose notifications and dose alerts—that warn operators and physicians when dose exceeds established thresholds.
  • Automatic exposure controls (AEC), which automatically adjust the amount of radiation within prescribed bounds as needed to achieve the desired image quality. Studies of AEC procedures have demonstrated dose reductions when used properly.
  • Pediatric and adult reference protocols, a set of pre-loaded parameters on a CT system that can be selected by the operator to complete a particular clinical task, such as capturing an image of the abdomen.

According to the Food and Drug Administration (FDA), it values the collaboration and work done by industry and the medical imaging community to promote patient safety.

“We also encourage radiology facilities to use equipment safety features and to adopt imaging best practices,” said Mary Pastel, PhD, Deputy Director for Radiological Health, Office of In Vitro Diagnostics and Radiological Health, FDA Center for Devices and Radiological Health.

XR 29 is the fourth dose-related standard to be released by MITA since 2010. Collectively, the series promotes adoption and use of advances in dose management and mitigation:

  • XR 25 Computed Tomography Dose Check incorporates dose notifications and alerts.
  • XR 26 Access Controls for Computed Tomography: Identification, Interlocks, and Logs requires software features ensuring that only an authorized operator can alter the controls of CT equipment.
  • XR 27 X-Ray Equipment for Interventional Procedures User Quality Control Mode helps imaging facilities conduct quality testing and monitoring of X-ray equipment used for interventional procedures.
View the contents and scope of NEMA XR 29-2013. A hard or electronic copy may be purchased for $51 by visiting global.ihs.com, or contacting IHS by phone at 800-854-7179 (U.S. only) or 303-397-7956 (international).