Page 111 - Medicare Benefit Policy Manual

80.4.2 - Applicability of Health and Safety Standards
(Rev. 1, 10-01-03)
B3-2070.4.B

The health and safety standards apply to all suppliers of portable x-ray services, except
physicians who provide immediate personal supervision during the administration of
diagnostic x-ray services. Payment is made only for services of approved suppliers who
have been found to meet the standards. Notice of the coverage dates for services of
approved suppliers are given to A/B MACs (B) by the RO.

When the services of a supplier of portable x-ray services no longer meet the conditions
of coverage, physicians having an interest in the supplier’s certification status must be
notified. The notification action regarding suppliers of portable x-ray equipment is the
same as required for decertification of independent laboratories, and the procedures
explained in §80.1.3 are followed.

80.4.3 - Scope of Portable X-Ray Benefit
(Rev. 71, Issued: 05-25-07, Effective: N/A; Implementation: July 2, 2007)

In order to avoid payment for services, which are inadequate or hazardous to the patient,
the scope of the covered portable x-ray benefit is defined as:

• Skeletal films involving the extremities, pelvis, vertebral column, or skull;

• Chest films which do not involve the use of contrast media (except routine
screening procedures and tests in connection with routine physical examinations);

• Abdominal films which do not involve the use of contrast media; and

• Diagnostic mammograms if the approved portable x-ray supplier, as defined in 42
CFR part 486, subpart C, meets the certification requirements of section 354 of
the Public Health Services Act, as implemented by 21 CFR part 900, subpart B.

80.4.4 - Exclusions From Coverage as Portable X-Ray Services
(Rev. 1, 10-01-03)
B3-2070.4.D

Procedures and examinations which are not covered under the portable x-ray provision
include the following:

• Procedures involving fluoroscopy;

• Procedures involving the use of contrast media;