What is XR-29?


We have many customers asking us about "low dose" CT equipment and XR-29 compliance. XR-29 does not mean "low dose" though it does mean the government recognizes compliance with their XR-29-2013 CT (Standard Attributes on CT Equipment Related to Dose Optimization and Management) standard, also known as Smart Dose CT. Some may confuse XR-29 with Iterative Reconstruction. We will write about IR in the next post. 

The XR-29 standard consists of four components:

  • DICOM Radiation Dose Structured Reports (DICOM RDSR) capture pre- and post-exam information in a standardized electronic format. A report must be included with each scan.
  • Pre-loaded reference protocols must be included for both pediatric and adult patients. 
  • Dose check technology alerts the user when a scan is estimated to be above dose limitations. 
  • Automatic exposure control adapts according to the part of the body being scanned.

XR-29 affects the Medicare Part B reimbursement payments from the government and does not apply to PET/CT. In April 2014, the President signed into law the Protecting Access to Medicare Act of 2014. In 2016, the government said it would pay less for some CT scans that occur on CT equipment that doesn't meet the XR-29 CT standard.

Some hospitals and imaging centers may have equipment that meets the government standards in regards to XR-29. Others may opt to upgrade their equipment or replace the system for one that meets the newer standards. If hospitals and imaging centers do not upgrade or replace their equipment that is not compliant with XR-29, they face reimbursement cuts. A question remains how to manage the paperwork and reimbursements for hospitals and imaging centers with more than one scanner where one may be compliant and one isn't. 

If your CT equipment does not meet each of the attributes of National Electrical Manufacturers Association (NEMA) Standard XR-29, your reimbursement under the legislation will now be reduced by 15%. The 15% reimbursement deduction began in 2017.

You can read more about the legislation HERE

It is important to run your numbers and understand if it is worth it to your site to purchase a new CT scanner, or stick with what you have. Over the long run, it might be worth it for you, depending on how many patients you have, to look into getting CT equipment that meets each of the attributes of National Electrical Manufacturers Association (NEMA) Standard XR-29. 

Contact us if you are looking to find a new CT scanner that has XR-29. We will walk you through the process.