Teleradiology/ Teleimaging
DESCRIPTION
Teleradiology/ Teleimaging is the process of electronically transmitting diagnostic and radiographic images, from one location to another for interpretation and/or consultation. Digitally transmitted images can be presented, analyzed and discussed simultaneously at different sites.
POLICY
The professional component for the diagnostic service of Teleradiology/ Teleimaging is considered medically necessary if the medical appropriateness criteria are met. (See Medical Appropriateness below.)
MEDICAL APPROPRIATENESS
Teleradiology/ Teleimaging is considered medically appropriate if ALL of the following criteria are met:
Images are of sufficient resolution for the physician to provide high quality care
Out of state physicians practicing teleradiology must meet the State of Tennessee's licensure requirements
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
Both the American College of Radiology and the American Medical Association recommend that those physicians using Teleradiology/ teleimaging should be licensed in both the state where the images were generated and the state where the images are interpreted. Equipment specifications should ensure the same image quality and availability if used for the initial diagnostic image interpretation, or for a review. Privacy concerns will also need to be secured for all transmissions and storage of images.
SOURCES
Adam, A., Dixon, A., Grainger, R., & Allison, D. (Eds.). (2008). Grainger & Allison’s Diagnostic Radiology A Textbook of Medical Imaging (5th ed., pp. 23 - 24). Churchill Livingstone: Elsevier.
American College of Radiology. (2004). ACR Practice guideline for radiologist coverage of imaging performed in hospital emergency departments. Retrieved August 5, 2009 from http://www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines/dx/hospital_er%20_imaging.aspx.
American College of Radiology. (2004). Teleradiology. Retrieved August 5, 2009 from http://www.acr.org/SecondaryMainMenuCategories/GR_Econ/FeaturedCategories/congressional/FederalLegislativeIssues/Teleradiology.aspx.
American College of Radiology. (2007). ACR Technical standard for electronic practice of medical imaging. Retrieved June 30, 2011 from http://www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines/med_phys/electronic_practice.aspx.
American Medical Association. (2008). H-480.968 Telemedicine. Retrieved August 5, 2009 from http://www.ama-assn.org/ad-com/polfind/Hlth-Ethics.pdf.
American Telemedicine Association. (2007, November, Updated February 2008). Core Standards for Telemedicine operations. Retrieved June 30, 2011 from http://www.americantelemed.org/files/public/standards/CoreStandards_withCOVER.pdf.
Complete Guide to Medicare Coverage Issues [Computer software]. (2011, April). Telehealth services (NCD 270, p. 4-289 to 4-294). Ingenix.
Muengtaweepongsa, S., Dharmasaroja, P., Maungboon, P, & Wattanaruangkowit, P. (2010). Feasability and safety of remote radiology interpretation with telephone consultation for acute stroke in Thailand. Neurology India, 58 (5), 740-742.(Level 4 Evidence - Independent)
Schwamm, L., Audebert, H., Amerenco, P., Chumbler, N., Frankel, M.,George, M. et al. (2009). Recommendations for the implementation of telemedicine within stroke systems of care: A policy statement from the American Heart Association/American Stroke Association, Stroke. Journal of American Heart Association, 40 (7), 2635-2660.
Schwamm, L., Holloway, R., Amerenco, P., Audebert, H., Bakas, T., Chumbler, N. et al. (2009). A review of the evidence for the use of telemedicine within stroke systems of care: A scientific statement from the American Heart Association, Stroke. Journal of American Heart Association, 40 (7), 2616-2634.
Tennessee Code: Title 63 Professions of the Healing Arts: Chapter 6 Medicine and Surgery: Part 2 General Provisions, Issue of licenses: TENN CODE ANN. § 63-6-209 (b).Retrieved August 5, 2009 from http://www.michie.com/tennessee/lpext.dll?f=templates&fn=main-h.htm&cp=tncode.
U. S. Food and Drug Administration. (2003, July). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K031778. Retrieved August 5, 2009 from http://www.accessdata.fda.gov/cdrh_docs/pdf3/K031778.pdf.
U. S. Food and Drug Administration. (2006, November). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K063093. Retrieved August 5, 2009 from http://www.accessdata.fda.gov/cdrh_docs/pdf6/K063093.pdf.
U. S. Food and Drug Administration. (2007, June). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K0712979. Retrieved June 30, 2011 from http://www.accessdata.fda.gov/cdrh_docs/pdf7/K071297.pdf.
U. S. Food and Drug Administration. (2008, June). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K081469. Retrieved June 30, 2011 from http://www.accessdata.fda.gov/cdrh_docs/pdf8/K081469.pdf.
Winifred S. Hayes, Inc. Medical Technology Directory. (2009, August). Teleradiology for neurological consultations. Retrieved June 30, 2011 from www.Hayesinc.com/subscribers. (27 articles and/or guidelines reviewed)
ORIGINAL EFFECTIVE DATE: 12/8/1997
MOST RECENT REVIEW DATE: 9/22/2011
ID_BT
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.