In April, 2004 Pacific Vascular Achieved status as an IDTF (Independent Diagnostic Testing Facility). This is a change in classification with the Medicare Program.

42 CFR 410.33 states that an Independent Diagnostic Testing Facility (IDTF) may be a fixed location, a mobile entity, or an individual nonphysician practitioner. It is independent of a physician's office or hospital; however, these rules apply when an IDTF furnishes diagnostic procedures in a physician's office. Furthermore, the Medicare Program Integrity Manual Chapter 10 § 5.1 notes that if a substantial portion of a physician or group practice of physicians business involves the performance of diagnostic tests, the diagnostic testing services may be a sufficiently separate business to warrant enrollment as an IDTF (it is considered independent for purposes of enrollment). In that case, the physician or group can continue to be enrolled as a physician or a group practice of physicians, but must also enroll as an IDTF. The physician or group can bill for professional fees and the diagnostic tests they perform on their patients using their billing number. However, the practice must bill as an IDTF for diagnostic tests furnished to Medicare beneficiaries who are not patients of the practice. The carrier should advise the entity (physician or group practice) how to bill for physician office tests versus IDTF tests and advise the claims personnel of the dual enrollment.

Non-physician personnel must demonstrate basic qualifications to perform the tests and have training and proficiency as demonstrated by licensure or certification by an appropriate state health or education department. For this reason, all Pacific Vascular Technologists must successfully complete the minimum prerequisites to sit for and pass the vascular registry examinations offered through the ARDMS (American Registry of Diagnostic Medical Sonographers) to become Registered Vascular Technologists - RVTs.

All procedures performed by the IDTF must be specifically ordered in writing by the physician who is treating the beneficiary for a specific medical problem and who uses the test results in the management of the beneficiary's specific medical problem. The written order must specify the diagnosis or basis for testing, the tests ordered, and the signature of the ordering physician. For this reason, Pacific Vascular must comply by requiring a written order for each requested exam. (Click here for a referral slip).

To ensure quality and accuracy of information submitted to CMS, laboratory site visits are performed on an unannounced basis. A site inspector will verify the existence of the lab, and can inspect the testing equipment and various tests being performed.

As a company committed to the highest standards and full compliance with all rules and regulations related to our field, PVI is extremely proud to have achieved this status. In many respects, the standards required of an IDTF far exceed those of other provider types, for instance, the requirement that testing be performed by an RVT is not required of vascular laboratories in hospitals or physician's offices (except those required to become IDTFs). Thus, becoming an IDTF is very much in keeping with PVI's desire to not only meet generally accepted standards, but to exceed them.

Pacific Vascular Laboratories have achieved re-accreditation by the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL) for these examinations:

• Extracranial Cerebrovascular
• Intracranial Cerebrovascular
• Peripheral Arterial
• Peripheral Venous
• Visceral Vascular

Pacific Vascular initially received accreditation in 1993.

The ICAVL, a non-profit organization established with the support of eleven medical societies, provides a mechanism for accrediting facilities which perform comprehensive testing for vascular disease with noninvasive testing modalities. Eleven sponsoring societies represent radiology, ultrasonography, vascular surgery, neurology, cardiology, neurosurgery, and internal medicine.

Accreditation signifies that the facility has been reviewed by an independent agency. Participation in the accreditation is voluntary and demonstrates the laboratory's concern for high quality patient care and attention to quality assurance.