September 06, 2018

NEMA XR-29 Update: ACR Standard Verification Process and New FAQ

Federal law requires health care providers to comply with the National Electrical Manufacturers Association (NEMA) XR-29 Standard Attributes on CT Equipment Related to Dose Optimization and Management for full reimbursement.

The NEMA XR-29 standard (MITA Smart Dose) specifies the following four attributes of CT scanners that contribute to optimization of ionizing radiation doses while still enabling the system to deliver the diagnostic image quality needed by the physician:

  • DICOM-compliant radiation dose structured reporting — See NEMA XR 29-2013 (Standard Attributes on CT Equipment Related to Dose Optimization and Management) and dicom.nema.org
  • Dose check features — See NEMA XR 25-2010 (Computed Tomography Dose Check)
  • Automatic exposure control — See NEMA XR-28-2013 (Supplemental Requirements for User Information and System Function Related to Dose in CT)
  • Reference adult and pediatric protocols — See NEMA XR-28-2013 (Supplemental Requirements for User Information and System Function Related to Dose in CT)

CT equipment that does not comply with all four attributes of the NEMA XR-29 Standard is subject to a 15% reduction in the payments for the technical component of CT services that utilize non-XR-29-compliant equipment.

It is important to note, however, that compliance with NEMA XR-29 is not required for ACR Accreditation.

ACR Policy for Verification of Compliance

Information about the NEMA XR-29 compliance status of CT equipment must be verified as part of the periodic accreditation of CT facilities. ACR Accreditation surveyors will verify which CT units are compliant with NEMA XR-29 by asking the facility being surveyed for certificates of compliance (or other acceptable documentation) for each CT unit owned or operated by that provider.

At the time of the performance of a validation survey, the ACR will verify the documentation of NEMA XR-29 compliance status for each accredited CT unit owned or operated by the supplier being surveyed.

If any CT unit owned or operated by a provider does not meet the NEMA XR-29 standard, the surveyor will note it in the facility’s accreditation file, and the ACR will submit information about the non-compliant CT units on the NEMA XR-29 Non-Compliance Reporting spreadsheet to CMS quarterly.

What You Need to Know

CT equipment users should refer to recently updated ACR frequently asked questions (FAQ) on compliance requirements for the NEMA XR-29 (MITA Smart Dose Standard).