September 09, 2021

Using the DIR for MIPS Submission

The ACR Dose Index Registry (DIR) is one of eight registries that comprise the ACR National Radiology Data Registry (NRDR®). Since 2011, the ACR DIR has helped clinicians and facilities improve the quality of patient care by collecting CT dose data through automated data transmission and leveraging that data to provide feedback on specific dose indices to participants and to establish national benchmarks.

The DIR offers a quality measure, ACRad 34, to help fulfill Merit-based Incentive Payment System (MIPS) reporting requirements. The DIR currently accepts secondary capture (or dose screen) as a method for data transmission via the ACR® TRIAD software. However, the preferred mechanism for data transmission to TRIAD for the DIR is via Radiation Dose Structured Report (RDSR).

Important Notice for Secondary Capture Users

If your practice intends to submit the DIR measure to MIPS for performance year 2021, be sure to review the Exam Search tab of the DIR Interactive Report to monitor the percentage of exams being submitted for the measure using secondary capture. Facilities using this method to submit data are more likely to undergo audit by the ACR prior to submission to CMS for MIPS consideration.

Need help? If you are submitting a high percentage of exams using secondary capture, visit the NRDR helpdesk and submit a ticket to request assistance.

DIR Is Moving to Exclusive Support of RDSR

For performance year 2022, all participants in the DIR will be required to send dose records only using the RDSR. Secondary capture images will no longer be accepted.

If your facility has been using secondary capture to submit records to the DIR, it’s easy to switch to RDSR and improve your data accuracy. Please reach out to the TRIAD support team via email at if you need assistance in the conversion process.

For more information about submitting data to the DIR, view the Dose Index Registry (DIR) Start Up Guide or consult DIR Data Collection and Submission Using TRIAD™ to learn how data is collected using TRIAD.