The US Mammography Quality Standards ACT (MQSA)

Question 1

What is the main purpose of the MQSA?

Answer 1

To establish minimal national quality standards for mammography

Question 2

What is the basic difference between accreditation and certification?

Answer 2

Accreditation is the initial step where the facility has to show that it meets the standards under the MQSA. Certification is the final step where the facility is granted a certificate allowing the facility to legally perform mammograms.

Question 3

For how long is the provisional certificate valid?

Answer 3

3-6 months

Question 4

Apart from the ACR, name the three other accreditation bodies in the United States.

Answer 4

States of Arkansas, Iowa, and Texas

Question 5

For how long is the certification valid?

Answer 5

3 years however, to maintain certification the facility must: be inspected annually by the FDA or state inspectors: have specific mammography equipment that is periodically surveyed by a medical physicist; empty specially trained personal to perform mammography and conduct regular quality control test; have a quality assurance program; have a system in place to track mammograms that require follow-up studies or biopsies; and have a tracking system in place to obtain biopsy results.

Question 6

If a facility receives a “level 2 finding or observation,” what does this mean?

Answer 6

There are one or more deviations that could compromise the quality of the mammography service.

Question 7

Before a site can stop performing mammograms, how does the site handle the patient’s medical records?

Answer 7

The facility must first transfer the medical record to a facility where the patient will be receiving future care, another physician or healthcare provider or the patient.

Question 8

If a facility has a certified analog mammography unit, can they legally operate an FFDM unit?

Answer 8

No. There is now a separate accreditation and certification process for FFDM units.

Question 9

Why was xeroradiography banned?

Answer 9

The units did not meet the dose limits of the MQSA.

Question 10

How could a site satisfy the consumer complaints mechanism policy under MQSA?

Answer 10

By posting the following notice, “If there are any questions or comment about your mammogram please contact… listing a contact name, title, and telephone number of email.

Question 11

How long must a facility keep the patients medical records?

Answer 11

Not less than 5 years or not less than 10 if the patient has no additional mammograms at the site. State laws may impose higher restrictions.

Question 12

Name the four basic content categories of a mammography report.

Answer 12

Name of patient plus an additional patient identifier, date of the examination, name of interpreting physician, and overall assessment of findings.

Question 13

Describe the meaning of a “suspicious” assessment category.

Answer 13

The finding has some but not all the characteristics of malignancy.

Question 14

What is a medical audit?

Answer 14

The physician should be notified of concern finding within 3-5 days.

Question 15

What is a medical audit?

Answer 15

A method of tracking positive mammography results t correlate pathology results with the interpreting physician’s findings.

Question 16

How has the HIPAA regulations affected the keeping of medical audits under MQSA?

Answer 16

HIPAA will not affect the keeping of medical audits.

Question 17

Before independently performing mammograms, what is the required minimum number of examinations the technologist must perform under direct supervision of a qualified technologist.

Answer 17

25

Question 18

To continue interpreting mammograms, what is the minimum number of examinations the interpreting physicians must read each 24 months/

Answer 18

960

Question 19

To meet continuing qualifications, the medical physicist must complete how many continuing education credits every 36 months?

Answer 19

15 CEU’s

Question 20

What would be the first step in improving the true positive rates at any facility?

Answer 20

Conduct regular reviews of the medical audit.

Question 21

The pathology review is a
A. method of tracking and reviewing all positive findings from the record
B. process of eliminating all positive findings from the record
C. method of tracking cosmetic intervention
D. process of identifying all mammoplasty

Answer 21

A. method of tracking and reviewing all positive findings from the record

Question 22

Elements considered essential to implementing a viable quality assurance program include:

1. evaluation
2. review
3. tolerance

Answer 22

Evaluation, review and tolerance

Question 23

The advantages of the MQSA include all of the following EXCEPT:
A. increase efficiency
B. cost-effectiveness
C. allows manipulation of the final image
D. improved patient satisfaction

Answer 23

C. allows manipulation of the final image, which is an option available with digital technology, however, digital technology is not a requirement for MQSA

Question 24

The patient will not have to authorize the release of biopsy results as required under HIPAA regulations because
A. MQSA inspectors are allowed to authorize the transfer of any patients records
B. HIPAA regulations allow a person subject to FDA jurisdiction to collect patients’ biopsy information for MQSA medical outcome audit.
C. generally, on admission to a hospital or medical facility, the patient will sign a release of records agreement authorizing their medical result transfer
D. Patients medical results can be shared with other facilities

Answer 24

B. HIPAA regulation only allows release of information related to the patients breast being imaging or biopsy. No other releases are allowed. In addition, the general consent signed by patients at many facilities allows release for insurance purposes and does not allow the sharing of patients medical information between facilities.

Question 25

``` If a mammography report is highly suspicious, the facility is required to communicate the results to the patient's physician within A. 30 days B. on day of mammogram C. 3-5 days of the mammogram D. 5 days of the interpretation ```

Answer 25

Normal results must be sent to a patient within 30 days. A suspicious finding must be sent within 3-5 days of the interpretation t the patients health care provider.

Question 26

``` The BIRAD category for a negative mammogram is: A. BIRAD 6 B. BIRAD 5 C. BIRAD 1 D. BIRAD 0 ```

Answer 26

C. BIRADS 0 --needs additional evaluations or comparisons. BIRADS 5 --suggestive of malignancy. BIRAD 6 patient had a prior positive biopsy.

Question 27

Under MQSA guidlines, if the patient does not return to a facility for additional mammograms, the radiographs and medical records must be kept: A. forever B. not less than 10 years C. not less than

Answer 27

B. the mammography records must not be kept for not less than 5 years if the patient returns for mammograms at the facility. If the patient does not return, the facility must keep the records for not less than 10 years. some state or local laws may require longer storage time.

Question 28

``` If there are two or more mammography units at a facility, the MQSA certificate must be placed in the: A. main mammography room B. office of the chief technologist C. waiting area visible to all patients D. office of the radiologist ```

Answer 28

C. The MQSA certificate must be visible to all patients coming to the facility. A general waiting area is an ideal place, however if needed, the facility can obtain additional copies for placement in individual mammography rooms.

Question 29

All technologist are required to complete:

Answer 29

15 CEs in mammography are required during the 36 months immediately preceding the last inspection

Question 30

The technologist initial mammography qualifications required by MQSA includes: 1. completion of a 40-hour mammography course 2. completion of 25 supervised examinations 3. 8 hours of specific training to digital

Answer 30

All, 1,2 and 3