- Protecting Access to Medicare Act (PAMA)
The Protecting Access to Medicare Act (H.R. 4302; P.L. 113-93), also known as PAMA, enacted in 2014, amended the Social Security Act (the Act) to extend Medicare payments to physicians and other providers of the Medicare and Medicaid program. Section 218(a) of the Protecting Access to Medicare Act (PAMA) requires that ADI suppliers and hospital outpatient areas providing CT services must meet safety requirements under NEMA Standard XR-29-2013 beginning on January 1, 2016. ADI suppliers and hospital outpatient departments that are non-compliant with these safety requirements must use a Current Procedural Terminology (CPT) code modifier on their Medicare billing to attest to non-compliance. These non-compliant ADI suppliers will receive a decrease in their Medicare payment of 5% in 2016 with a further reduction to 15% in 2017 and thereafter.
- Excerpts specific to CT from HR Bill 4302
- Policy on CT Whole Body Screening
- MITA Smart Dose CT
The MITA Smart Dose standard offers healthcare providers a reference to identify important tools to optimize and manage radiation dose delivery when using computed tomography (CT) equipment.
New York State Law Requiring CT Imaging Facility Accreditation
A New York state law requires advanced diagnostic imaging facilities in the state of New York performing CT examinations to acquire accreditation within 18 months of the law’s effective date of January 20, 2016.
- American Academy of Neurology (AAN)
- American Academy of Otolaryngology - Head and Neck Surgery (AAOHNS)
- American Association of Physicists in Medicine (AAPM)
AAPM has created a website that contains suggests imaging parameters for specific makes/models of CT units. These imaging parameters include appropriate technical factors (kV, mA, rotation time, etc.) that yield an acceptable patient radiation dose and imaging quality. Refer to www.aapm.org/pubs/CTProtocols to view imaging parameters for:
- American Association of Oral and Maxillofacial Surgeons (AAOMS)
- American Society of Echocardiography (ASE)
- American Society of Nuclear Cardiology (ASNC)
- American Society of Radiologic Technologists (ASRT)
- International Commission on Radiation Protection (ICRP)
- Radiological Society of North America (RSNA)
- Society for Cardiovascular Angiography and Interventions (SCAI)
- Society for Vascular Surgery (SVS)
- Society of Cardiovascular Computed Tomography (SCCT)
- Society of Nuclear Medicine (SNM)
- U.S. Food and Drug Administration Center for Devices and Radiological Health (CDRH)
- FDA Guidelines for CT Procedures and Screening
- CT ANGIOGRAPHY OF PERIPHERAL ARTERIAL DISEASE
Lower-extremity computed tomographic (CT) angiography (i.e., peripheral CT angiography) is increasingly used to evaluate patients with peripheral arterial disease. It is therefore increasingly important for all vascular specialists to become familiar with the strengths and limitations of this new technique. The aims of this review are to explain the principles of scanning and injection technique for a wide range of CT scanners, to explain and illustrate the properties of current image postprocessing tools for effective visualization and treatment planning, and to provide an overview of current clinical applications of peripheral CT angiography.
- AAO-HNS ENDORSES POINT-OF-CARE IMAGING IN OTOLARNGOLOGY
The American Academy of Otolarngology-Head and Neck Surgery (AAO-HNS) recently released a policy statement endorsing point-of-care imaging in an effort to represent a modality of service that is in line with the Institute of Medicine’s six dimensions of high quality care. AAO-HNS is a sponsoring organization of the Intersocietal Commission for the Accreditation of Computed Tomography Laboratories (ICACTL).
- CONFERENCE OF RADIATION CONTROL PROGRAM DIRECTORS
The Conference of Radiation Control Program Directors, Inc. (CRCPD) is a 501(c)(3) nonprofit non-governmental professional organization dedicated to radiation protection. CRCPD's mission is "to promote consistency in addressing and resolving radiation protection issues, to encourage high standards of quality in radiation protection programs, and to provide leadership in radiation safety and education. CRCPD Specific to CT section»
- FDA Information Regarding Cone-Beam Computed Tomography
On this webpage, the FDA is providing: information about the use of cone-beam computed tomography in dentistry particularly in the pediatric population; information for patients, parents and health care providers to help reduce unnecessary radiation exposure from dental cone-beam computed tomography; and, resources for manufacturers of dental cone-beam computed tomography devices.
- Manual on Contrast Media, American College of Radiology. www.acr.org/Clinical-Resources/Contrast-Manual
- ACCF/AHA Clinical Competence Statement on Cardiac Imaging With Computed Tomography and Magnetic Resonance - A Report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training: Developed in Collaboration With the American Society of Echocardiography, American Society of Nuclear Cardiology, Society of Atherosclerosis Imaging, and the Society for Cardiovascular Angiography & Interventions: Endorsed by the Society of Cardiovascular Computed Tomography. Budoff, M, et al., Circulation, 2005; 46(2):383-402. www.ahajournals.org/doi/abs/10.1161/circulationaha.105.168237
- Reference Values for Diagnostic Radiology: Application and Impact. Gray, J, et al., Radiology, 2005; 235(2):354-358. pubs.rsna.org/doi/full/10.1148/radiol.2352020016
- Radiation Safety in the Practice of Cardiology. Limacher, M., et al., J Amer Coll Cardiol, 1998; 31(4):892-913. www.onlinejacc.org/content/accj/31/4/892.full.pdf
- Radiation Protection in Humans: Extending the Concept as Low as Reasonably Achievable (ALARA) from Dose to Biological Damage. Prasad, KN, et al., British Journal of Radiology, 2004; 914:97-9. www.birpublications.org/doi/full/10.1259/bjr/88081058
- American Association of Physicists in Medicine Report No. 3: Assessment of Display for Medical Imaging Systems. www.aapm.org/pubs/reports/OR_03.pdf
- American Association of Physicists in Medicine Report No. 1: Phantoms for Performance Evaluation and Quality Assurance of CT Scanners. www.aapm.org/pubs/reports/RPT_01.pdf
- Task Force 13: Training in Advanced Cardiovascular Imaging (Computed Tomography) - Endorsed by the American Society of Nuclear Cardiology, Society of Atherosclerosis Imaging and Prevention, Society for Cardiovascular Angiography and Interventions, and Society of Cardiovascular Computed Tomography. Budoff, M, et al., J Amer Coll Cardiol, 2008; 51(3):409-414. www.onlinejacc.org/content/51/3/409
- Incidental Findings with Cardiac CT Evaluation – Should We Read Beyond the Heart? Budoff, M, et al., Catheter Cardiovasc Interv, 2006; 68(6):965-973. onlinelibrary.wiley.com/doi/10.1002/ccd.20924/full
- ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 Appropriateness Criteria for Cardiac Computed Tomography and Cardiac Magnetic Resonance Imaging - A Report of the American College of Cardiology Foundation Quality Strategic Directions Committee Appropriateness Criteria Working Group, American College of Radiology, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, American Society of Nuclear Cardiology, North American Society for Cardiac Imaging, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology. Hendel, R, et al., J Amer Coll Cardiol, 2006;48(7):1475-1497. www.onlinejacc.org/content/48/7/1475
- Trends in Adverse Events After IV Administration of Contrast Media. Cochran, S, et al, AJR Am J Roentgenol, 2001;176(6):1385-1388. www.ajronline.org/doi/pdf/10.2214/ajr.176.6.1761385
- CT Angiography of Peripheral Arterial Disease. Fleischmann, D, et al., J Vasc Interv Radiol, 2006;17(1):3-26. www.jvir.org/article/S1051-0443(07)60870-7/fulltext
- Pregnancy and Medical Radiation: International Commission on Radiation Protection (ICRP) Publication 84. www.icrp.org/publication.asp?id=icrp%20publication%2084
- Managing Patient Dose in Computed Tomography: International Commission on Radiation Protection (ICRP) Publication 87. www.icrp.org/publication.asp?id=ICRP%20Publication%2087
- Structural Shielding Design for Medical X-ray Imaging Facilities: NCRP Report No. 147 (2004). ncrponline.org/shop/reports/report-no-147-structural-shielding-design-for-medical-x-ray-imaging-facilities-2004/
- U.S. Food & Drug Administration Center for Devices and Radiological Health (CDRH) (2006). Performance Standards for Ionizing Radiating Products. Code of Federal Regulations: 21 CFR Sect. 1020.33. www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?fr=1020.33
- Compliance Guidelines for Computed Tomography Quality Control. New Jersey Department of Environmental Protection, 2001. www.state.nj.us/dep/rpp/qa/qa_down/ctcgd.pdf