by
Lauren Dubinsky, Senior Reporter | September 23, 2016
From the September 2016 issue of HealthCare Business News magazine
Traditionally, 70kV has been used primarily on pediatric patients because the conventional X-ray tubes didn’t have enough mA to accommodate older patients. But the Force has 2,600 mA combined, which allows clinicians to image adult patients at 70, 80 and 90 kV.
XR-29
XR-29, also known as the Medical Imaging and Technology Alliance (MITA) Smart Dose, was put into place in 2014. As of Jan. 1, 2016, services performed on noncompliant CTs are reimbursed with a 5 percent reduction, and in 2017 reimbursement will be cut by 15 percent. The penalties only apply to the technical component and only affect Medicare and outpatient facilities — not hospital inpatient settings. The facilities have to comply with four criteria to avoid a reimbursement cut.
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The scanners must be able to notify the user about potential over-radiation and document it as well as capture and report the dose information in a consistent manner. Pediatric and adult reference protocols need to be in place and the X-ray tube current must be regulated based on the region of the body that is scanned. “I think it has caused financial discomfort for some hospitals,” says Keith Mildenberger, CT product manager at Neusoft Medical Systems USA Inc. “There was a feeling by many in the diagnostic imaging community that the deadline for compliance would be delayed by CMS.”
Because of that, many hospitals didn’t budget for their systems to be replaced or upgraded, and as a result, were not prepared for the deadline. Mildenberger believes that the biggest impacts will come when hospitals realize that the used equipment they purchased that was promised to be compliant, actually isn’t. They may also find out that the “NEMA XR-29 compliance solution” from a third-party company “doesn’t pass muster with CMS.”
The FDA has not yet explicitly stated that regulatory clearance is a requirement for third-party XR-29 solutions. However, Medic Vision’s SafeCT-29 is the one solution on the market that scored FDA approval. When faced with the decision to purchase a new CT or retrofit an existing CT, it depends on the facility, says Judith Schmalzing, CT product marketing manager at Siemens.
If a hospital has multiple scanners and some are compliant, they can operate in that environment, but they need to triage their Medicare patients to the compliant CTs. “We advise our customers that it makes sense to upgrade their entire fleet because triaging patients can result in an administrative nightmare for hospitals, because they have to change their workflow,” says Schmalzing.
