by CCI Board
In April of 2010, Cardiovascular Credentialing International (CCI) launched the Phlebology Registry Examination and corresponding credential, the Registered Phlebology Sonographer (RPhS). This credential program was a collaborative effort with the American College of Phlebology (ACP), which approached CCI in 2007 to investigate the need for and ultimately develop a registry-level credential for phlebology ultrasound.
Phlebology Registry Examination
During our initial investigation, we determined that the Registered Vascular Specialist (RVS) and ARDMS credential Registered Vascular Technologist (RVT) did not speak to the didactic and clinical expertise of phlebology ultrasound professionals—specifically the diagnostic nuances, clinical background, and therapeutic applications of this specialty. The RPhS serves as the credential for this highly specialized field.
A Registered Phlebology Sonographer (RPhS) performs diagnostic tests and/or assists in non-surgical, open surgical, and minimally invasive treatments utilizing in-depth knowledge of venous diseases, anatomy, and pathophysiology to provide optimal patient outcomes and extend or enhance the quality of patients’ lives.
The specialization of sonographers in this area has been developing over the past 20 years, since the original inception of ultrasound-guided sclerotherapy for varicose veins.With the significant growth in the treatment of chronic venous insufficiency (CVI) over the past decade, the numbers of sonography professionals specializing in phlebology has grown. It is with pride that CCI announces the following development for the RPhS credential.
The RPhS credential was recently recognized by First Coast Service Options, Inc. (FCSO), the Medicare Administrative Contractor for J9 responsible for the provision of administrative services for physicians and health care providers located in Florida, Puerto Rico, and the U.S. Virgin Islands in the Training Requirements section. (Excerpt from LCD ID Number L29234, which includes CPT 93965, 93970, and 93971.) We are pleased with this first formal recognition of the RPhS credential by a regulatory agency. A content outline and study overview may be found here.
CCI Board 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 who has demonstrated minimum entry level competency by being credentialed in vascular technology, and/or (3) performed in a laboratory accredited in vascular technology.
General Supervision means the procedure is furnished under the physician’s overall direction and control, but the physician’s presence is not required during the performance of the procedure. Under general supervision, the training of the non-physician personnel who actually performs the diagnostic procedure and the maintenance of the necessary equipment and supplies are the continuing responsibility of the physician.
CMS Manual System stipulations
The CMS Manual System, Pub. 100-08, Program Integrity Manual, Chapter 13, Section 13.5.1 outlines that “reasonable and necessary” services are “ordered and/or furnished by qualified personnel.” Services will be considered medically reasonable and necessary only if performed by appropriately trained providers.
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 activities.
If these skills have been acquired by way of continued medical education, 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.