Answer to Question #12125 Submitted to "Ask the Experts"

Category: Medical and Dental Patient Issues — Diagnostic X Ray and CT

The following question was answered by an expert in the appropriate field:

Q

In the medical imaging department, we have a new policy requiring documentation of computed tomography (CT) dose results in our reports. For multiphase exams of the SAME anatomical segment, can we add the computed tomography dose index weighted (CTDIw) and dose-length product (DLP) of the different phases (including the scout image)? This simplification would increase compliance with the new policy.

A

As long as the same body area is irradiated, adding the CTDIw and DLP data would be acceptable for reconstruction of the patient dose. However, if the subsequent scans extend to different portions of the body than the initial scan, the dose data should be documented separately. I would make sure that the data is labelled as "total for x scans" (where x is the number of scans), so the data might not be misinterpreted as the dose for each of the scans.

I assume that you are doing this manually at the moment. However, there are requirements that are coming into effect from the Joint Commission and through the Medicare Access and CHIP Reauthorization Act (MACRA) that will require dosimetry data from medical x-ray exams to be electronically recorded in the patient's medical record. To manage this requirement, the medical industry is developing hardware and software solutions that automatically handle data. Once these solutions are implemented, each exam will have a separate record, and patient effective doses will be calculated by the program for insertion into the patient's permanent electronic medical record.

Michael J. Bohan, RSO

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