Dangerous or Hazardous Procedures
Dangerous or hazardous procedures are radiologic procedures which may only be performed by a practitioner (MD, DO, DC, DPM) in the course and scope of the license, or by a certified medical radiologic technologist (MRT, LMRT). The identification of these procedures in this format is authorized by the Medical Radiologic Technologist Certification Act, Texas Occupation Code, Section 601.056. LMRTs are limited to radiography of specific anatomical parts indicated on the limited certificate.
This chart is intended to be helpful in illustrating the radiologic procedures an MRT, LMRT, non-certified technician (NCT), RN or PA may perform. This list is for illustrative purposes only and is not exhaustive. For more information consult §140.516 of the rules.
Select the link below to download or print the "Dangerous or Hazardous Procedures" Table
DANGEROUS OR HAZARDOUS PROCEDURES TABLE
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§140.516(b) Dangerous procedures. Unless otherwise noted, the list of dangerous procedures which may only be performed by a practitioner or MRT are:
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P
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MRT
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LMRT
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RN/PA
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NCT
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1
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Nuclear medicine studies (to include PET)
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YES
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YES
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No
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No
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No
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2
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Administration of radiopharmaceuticals, unless performed by an RN or Physician Assistant who is appropriately trained as authorized by the department’s DSHS Radiation Control Program for licensure of radioactive materials;
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YES
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YES
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No
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YES
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No
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3
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Radiation therapy including simulation, brachytherapy and all external radiation therapy beams including Grenz rays;
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YES
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YES
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No
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No
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No
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4
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Computed tomography (CT) or any variation thereof;
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YES
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YES
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No
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No
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No
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5
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Interventional radiographic procedures, including angiography, unless performed by an LMRT with a certificate issued in the cardiovascular category;
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YES
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YES
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LMRT-CV
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No
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No
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6
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fluoroscopy and/or fluorography, unless performed by an LMRT with a certificate issued in the cardiovascular category, or by an appropriately trained* RN or physician assistant who assists in the performance of the procedure under the direct supervision of a practitioner;
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YES
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YES
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LMRT-CV
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YES
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No
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7
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cineradiography (including digital acquisition techniques), unless performed by an LMRT with a certificate issued in the cardiovascular category.
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YES
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YES
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LMRT-CV
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No
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No
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§140.516 (c) Hazardous procedures. Unless otherwise noted, the list of hazardous procedures which may only be performed by a practitioner or MRT are:
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|
|
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|
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1
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Conventional Tomography
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YES
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YES
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No
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No
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No
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2
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skull radiography
anterior-posterior/posterior-anterior (AP/PA), lateral, Townes, Caldwell, and Waters views;
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YES
YES
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YES
YES
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LMRT-Skull
LMRT-Skull
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No
YES
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No
YES
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3
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portable x-ray equipment;
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YES
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YES
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No
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No
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No
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4
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spine radiography
AP/PA, lateral and lateral flexion/extension views;
lumbar oblique views performed by an appropriately trained* RN or physician assistant who performs the procedure under the supervision of a practitioner;
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YES
YES
YES
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YES
YES
YES
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LMRT-Spine
LMRT-Spine
LMRT-Spine
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No
YES
YES
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No
YES
No
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Continued §143.16(c) Hazardous procedures. Unless otherwise noted, the list of hazardous procedures which may only be performed by a practitioner or MRT are:
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P
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MRT
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LMRT
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RN/PA
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NCT
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6
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shoulder girdle radiographs
excluding AP and lateral shoulder views, AP clavicle and AP scapula, unless performed by an appropriately trained* RN or physician assistant who performs the procedure under the direct supervision of a practitioner;
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YES
YES
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YES
YES
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LMRT-Extremities
LMRT-Extremities
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YES
YES
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No
YES
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7
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pelvic girdle radiographs
AP or PA views;
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YES
YES
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YES
YES
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No
LMRT-Extremities
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No
YES
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No
YES
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8
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sternum radiographs, unless performed by an appropriately trained* RN or physician assistant who performs the procedure under the direct supervision of a practitioner;
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YES
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YES
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No
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YES
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No
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9
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radiographic procedures which utilize contrast media, unless performed by an RN or physician assistant who assists in the performance of the procedure under the supervision of a practitioner.
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YES
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YES
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No
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YES
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No
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10
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pediatric radiography, excluding extremities, unless performed by an appropriately trained* RN or physician assistant or an LMRT with the appropriate category (relevant categories are: skull, chest, spine, extremities, and podiatry). If an emergency condition exists which threatens serious bodily injury, protracted loss of use of a bodily function or death of a pediatric patient unless the procedure is performed without delay, or if other extenuating circumstances deemed by the practitioner exist, a pediatric radiographic procedure is also excluded. The emergency condition or extenuating circumstance must be documented by the ordering practitioner in the patient's clinical record and the record must document that a regularly scheduled MRT, LMRT, RN or physician assistant is not reasonably available to perform the procedure.
Pediatric is defined as anyone under age of 18.
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YES
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YES
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No, unless the LMRT has certification in the appropriate category.
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YES
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No
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Pediatric extremities only.
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YES
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YES
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LMRT-Extremities
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YES
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YES
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Mammography is a radiologic procedure which may only be performed by an MRT.
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No
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YES
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No
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No
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No
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Key:
P – Practitioner is a doctor of medicine, osteopathy, podiatry, dentistry, or chiropractic who is licensed under the laws of this state and who prescribes radiologic procedures for other persons for medical reasons.
MRT – Medical Radiologic Technologist
LMRT – Limited Radiologic Technologist
RN/PA – Registered Nurse/Physician Assistant
NCT – Non-Certified Technician
*appropriately trained RN or PA as set out in 140.517 and 140.518 or 140.522
In Chapter 140.520 Hardship Exemptions:
(a) General.
(4) A hardship exemption granted by the department does not constitute licensure, certification, registration, or authorization to perform a dangerous or hazardous radiologic procedure or mammography.
For more information, please contact:
TDSHS - MRT Program
P.O. Box 149347, Mail Code 1982,
Austin, Texas 78714-9347
Phone (512) 834-6617, Fax (512) 834-6677.