ProviderPulse

Fluoroscopy and the Department of Health

From Pinnacol's Medical Director

June 2011

The requirements for physicians performing fluoroscopy in Colorado have changed.

The Medical Treatment Guidelines (MTG) from the Division of Workers’ Compensation note, “For all injections (excluding trigger point and occipital nerve blocks) multi-planar fluoroscopy, during procedures is required to document technique and needle placement, and should be performed by a physician experienced in the procedure.”


The MTG have been rather open on the issue of radiation safety, only noting that physicians “must also be knowledgeable in radiation safety.”

The MTG define the criteria for fluoroscopy here:


The Department of Health (DOH) has changed the requirements for physicians performing fluoroscopy in the state of Colorado. On July 30, 2010, the DOH issued 6 CCR 1007-1. Part 2, Section 2.6.1.5, lists the five criteria used to determine whether an individual is “adequately trained” in fluoroscopy performance:


The DOH added Section 2.6.1.5 to make certain of skill acquisition by physicians for equipment operation.


Part 6 further emphasizes the need to have “adequate radiation safety training and experience” in Section 6.5.1.2.

To complete the testing for compliance with Section 2.6.1.5, the DOH developed testing for fluoroscopists. The Rocky Mountain Chapter of the American Association of Physicists in Medicine (AAPM) created the testing process. You can visit the AAPM website to create a new account and then take of one of two tests. The AAPM then provides a certificate of completion through the website. The certificate should satisfy credentialing committees at all facilities. It will probably need to be renewed periodically as the physician recredentials. A hospital or outpatient facility may devise its own testing, but the testing requires review and approval by the DOH.

All physicians performing fluoroscopy must complete the required testing. Residency and board certification are not sufficient.


The one-year grace period for completion ends July 1, 2011.


DOH radiation inspectors will look for documentation of completion and will give a 30-day letter asking for completion to those not in compliance. If completion of fluoroscopic testing is not completed at re-auditing, a 60-day letter will follow.

If you have questions concerning the process, contact the DOH at cdphehmwmxraycomments@state.co.us.