Louisiana
FISCAL INTERMEDIARIES/MAC - PART A
"The accuracy of noninvasive vascular diagnostic studies depends on the knowledge, skill, and experience of the technologist and interpreter. Consequently, the providers of interpretations must be capable of demonstrating documented training and experience and maintain documentation for post-payment audit.
Furthermore, in those states with Carriers that have this requirement (e.g. Louisiana Part B effective January 1, 1997; Mississippi Part B, effective January 1, 1998; Medicare Part B Kansas/Nebraska/Western Missouri effective 12:01 A.M. July 1, 1998), all noninvasive vascular diagnostic studies must be either:
1. Performed by or under the direct supervision of a physician, or
2. Performed by or under the direct supervision of persons that have demonstrated minimum entry level competency by being credentialed in vascular technology, or
3. Performed in laboratories accredited in vascular technology.
"Direct supervision of a physician" means the physician must be present in the facility and immediately available to furnish assistance and direction throughout the performance of the procedure. Examples of appropriate personnel certification include the Registered Vascular Technologist (RVT) credential and the Registered Cardiovascular Technologist (RCVT) credential in Vascular Technology. Examples of appropriate laboratory accreditation include the American College of Radiology (ACR), Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL), or the Ultrasound Practice Accreditation Commission of the American Institute of Ultrasound in Medicine. Direct supervision requires the credentialed individuals physical presence in the facility during the examination."
WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION [FI]
www.wpsmedicare.com
A. Training and Certification:
1. The accuracy of non-invasive vascular diagnostic studies depends on the knowledge, skill, and experience of the technologist and interpreter. Consequently, the physician performing and/or interpreting the study must be capable of demonstrating documented training and experience and maintain any applicable documentation. A vascular diagnostic study may be personally performed by a physician or a technologist.
The GAO Report to Congressional Committees entitled Medicare Ultrasound Procedures.
Consideration of Payment Reforms and Technician Qualifications Requirements states that “Findings from several peer-reviewed studies, the Medicare Payment Advisory Commission,
and ultrasound-related professional organizations support requiring that sonographers either
have credentials or operate in facilities that are accredited, where specific quality standards
apply. In some localities and practice settings, CMS or its contractors have required that
sonographers either be credentialed or work in an accredited facility.” (GAO-07-734)
2. All non-invasive vascular diagnostic studies must be performed under at least one of the
following settings:
a. performed by a physician who is competent in diagnostic vascular
studies or under the general supervision of physicians who have demonstrated minimum
entry level competency by being credentialed in vascular technology, or
b. performed by a technician who is certified in vascular technology, or
c. performed in facilities with laboratories accredited in vascular technology.
3. One or more technologists in each vascular laboratory must be certified by a credentialing board recognized by the Intersocietal Commission for Accreditation of Vascular Laboratories (ICAVL) or the National Council for Certifying Agencies (NCCA) or the International Standards Organization (ISO) 17024).
4. Laboratories may be certified by the Intersocietal Commission for the Accreditation of Vascular Laboratories. Certification of the laboratory itself supersedes the requirement for certification of individual technologists."
These requirements will be necessary to payment of services provided beginning 05/01/2010.
MEDICARE CARRIERS/MAC - PART B
“The accuracy of noninvasive vascular studies depends on the knowledge, skill and experience of the technologist and interpreter. Consequently, the providers of interpretations must be capable of demonstrating documented training and experience and maintain documentation for post-payment audit. All noninvasive vascular diagnostic studies must be either 1) performed by, or under the general supervision of, persons that have demonstrated minimum entry level competency by being credentialed in vascular technology, or (2) performed in laboratories accredited in vascular technology. Examples of appropriate personnel certification include the Registered Vascular Technologist (RVT) credential and the Registered Vascular Specialist (RVS) credential in Vascular Technology, and appropriate laboratory accreditation include the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL), or the American College of Radiology (ACR). Effective January 1, 2005, documentation of either the RVS, RVT or facility accreditation will be required each January prior to billing electronically for that new year and with any and all submitted paper claims. Supervisory levels of diagnostic tests must be in accordance with Program Memorandum B-01-28.”
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