Accreditation of your office-based

vascular lab: A must

Jose I. Almeida, MD, FACS, RPVI, RVTDirector, Miami Vein Center

Voluntary Associate Professor of Surgery

University of Miami School of Medicine

Faculty DisclosureJose I. Almeida, MD, FACS, RPVI, RVT

1. Research grant supportAngioDynamics, Covidien, Sapheon, Vascular Insights

2. Managing PartnerVascular Device Partners, LLC

Why Become Accredited?

Process clearly organizes Vascular Laboratory

testing and improves quality of patient care.

Increase physician & patient referrals.

Will be required for reimbursement in the future…?

Accrediting Organizations

Organization Year

Founded

Accredited

Organizations

Joint Commission on

Accreditation of Healthcare

Organization

(JACHO)

1951 15,000

Accreditation Association for

Ambulatory Health Care

(AAAHC)1979 3,600

Intersocietal Commission

for the Accreditation of

Vascular Laboratories

(ICAVL)

1990

1229

(913 Venous)

Florida: 86

28 (33%) Hospital Based

Outpatient Surgery Safety Committee &

Florida Board of Medicine

Basic standards for Level I surgical procedures.

Rules for Level II and III anesthesia are more stringent.

All offices using IV sedation or general anesthesia

must be accredited by the JCAHO, AAAASF, AAAHC,

and adverse incidents must be reported to the Medical

Board of Florida.

Risk management program with detailed logs.

Balkrishnan R. Dermatol. Surg. 2003

AAAHC

ICAVL

$200 Application Kit

$1,000 Base Fee

$500 Supplies

$300 per Area of Accreditation –

Arterial1, Venous2, Extracranial3, Intracranial4,

Visceral5, and Screening6.

Contractor Name:

First Coast Service Options, Inc.

LCD Title:

Non-Invasive Evaluation of Extremity Vein

Contractor Number: 09101 & 09102Contractor Type:

Training Requirements

The accuracy of non-invasive vascular diagnostic studies depends on the

knowledge, skill and experience of the technologist and the physician

performing the interpretation of the study.

Consequently, the technologist and the physician must maintain proof of

training and experience.

All non-invasive vascular diagnostic studies must be:

(1) performed by a qualified physician, or

(2) performed under the general supervision of a qualified

physician by a technologist credentialed in vascular

technology, and/or

(3) performed in a laboratory accredited in vascular

technology.

A qualified physician for this service is defined as follows:

Training and expertise must have been acquired within

the framework of an accredited residency and/or fellowship

program in the applicable specialty/subspecialty or must

reflect extensive continued medical education (CME)

activities.

If these skills acquired by CME, the courses must be

comprehensive, offered or sponsored or endorsed by an

academic institution in the United States and/or by the

applicable specialty/subspecialty society in the United

States, and designated by the American Medical

Association (AMA) as Category 1 Credit.

Examples of certification in vascular technology for non-

physician personnel include:

Registered Vascular Technologist (RVT) credential

Registered Vascular Specialist (RVS) credential

These credentials must be provided by nationally

recognized credentialing organizations such as:

The American Registry of Diagnostic Medical

Sonographers (ARDMS) which provides RDMS and RVT

credentials

The Cardiovascular Credentialing International (CCI)

which provides RVS credential

Appropriate nationally recognized laboratory accreditation

bodies include:

Intersocietal Commission for the Accreditation of

Vascular Laboratories (ICAVL)

American College of Radiology (ACR)

However, if the facility has a documented process for grand-fathering

experienced technicians who have performed the services referenced in this

LCD (a process addressing years of service and experience with number of

supervised cases), this documentation should be available to Medicare upon

request; otherwise the provider must have documentation available to Medicare

upon request which indicates that the technician meets the credentialing

requirements as stated above or is in the process of obtaining this

credentialing.

Administrative Part

Practice Demographics

Practice History

Annual Volume

Staff (Medical Director, Technical Director, Technologists, and Medical Staff)

Credentials

Policies

QA

Instrumentation

Venous Part

Indications

Technical Protocols

Diagnostic Criteria

Correlation Analysis (Vascular Laboratory vs. Various Modalities)

Logs

Example Cases

STANDARD – Medical Director

1. must be designated for the facility.

Medical Director qualifications:

Supervises the entire operation; may delegate specific duties to

appropriate staff

Maintaining and assuring compliance to the standards as outlined

in this document

Comment: If the Medical Director is off site, he/she must have a

physical presence in the lab to participate in regular QA

meetings, case study review conferences, personnel interviews

and other laboratory operations.

STANDARD – Technical Director

1.must be designated for the facility.

2.generally a full-time position.

If the Technical Director is not onsite full time,

he/she must work a minimum of 20% of normal

business hours each month AND

An appropriately credentialed technologist must be

appointed in the Technical Director’s absence and

report to the Technical Director.

Comment: The Medical Director or a member of

the medical staff must satisfy the qualifications of

the Technical Director to serve in that capacity.

Jose I. Almeida, MD, FACS, RPVI, RVT

THE ICAVL DOES:

Attempt to stay abreast of payment

policies as a service to the vascular

community.

Communicate information to

vascular laboratories about

payment policies (through the

ICAVL website, newsletter articles)

THE ICAVL DOES NOT:

Establish rules or regulations for

the insurance carriers.

Thank you!

Conclusion:

Credentials, credentials,

credentials