This information is for NON-Imaging Personnel only (i.e.: nursing or allied health professionals) wishing to perform as a Limited X-ray Machine Operator (LXMO). All prerequisite requirements MUST be completed BEFORE requesting to take the State Examination administered by the ARRT.
Process for NEW applicants to become a licensed ND LXMO:
Brief Overview:
- NDAC 114-02-01-02(3) must first meet eligibility requirements of required Allied Health profession or petition Board for approval (Petitions should be made to the Board BEFORE completing approved didactic education).
To be eligible for licensure as a limited x-ray machine operator after completing the requirements of subsection 2, an applicant shall hold at least one of the following licenses:
- Medical technologist, medical laboratory technician, or clinical laboratory technician;
- Occupational therapist or occupational therapy assistant;
- Physical therapist or physical therapy assistant;
- Physician assistant or orthopedic physician assistant;
- Registered nurse or licensed practical nurse;
- Otherwise, an individual may petition the board for licensure if the individual's education background is substantially similar to the above. (Petitions should be made to the Board BEFORE completing approved didactic education)
Petitions
- The Board has recently denied petitions for phlebotomists and nursing assistants (whether certified or not) as not considered substantially similar to the programs already list on page 5 in NDAC 114-02-01-02(3).
- The Board has approved petitions for ND licensed, nationally registered and in good-standing EMT-Paramedics as recognized applicants to apply for LXMO licensure; the EMT-Basic and EMT-Advanced are NOT approved, only the EMT -Parmamedic.
- The Board has approved petitions for ND licensed and in good-standing Certified Clinical Chiropractic Assistant (CCCA) working in a chiropractic setting only to apply for a Restricted LXMO CCCA practicing in a chiropractic setting only.
- Apply online below for a Conditional License to practice as a LXMO.
- Complete the required Criminal History Record background Check (CHRC) forms. The applicant MUST have completed their structured academic program, submit the application, and complete the CHRC process before the Conditional License will be issued.
- NDAC 114-02-01-02(2) requires satisfactory completion of a board approved, structured academic program and demonstration of practical clinical competency documentation. More information can be found in the LXMO Clinical Competency Information Packet, use this packet if applying after March 1, 2023. If you have questions, please contact the board office.
It is the responsibility of the applicant to make arrangements to complete their clinicals. You may need to go to other facilities (hospitals, clinics, etc.) to complete your clinicals if they cannot be all completed at your current facility. You have 9 months to complete the clinical requirements.
Keep reading for more information on clinical requirements.- The Board strongly encourages not to have more than one individual completing clinicals at a time per facility, as this could cause too much competition in completing examinations in small low-volume department.
- Applicant must have arrangements in place to perform the clinical competency requirements ahead of time and inform the Board of what/where the facility will be utilized.
- After applicant is approved and completes the structured academic program (proof submitted) the office will issue a Conditional LXMO License to begin the demonstration of the practical clinical competency.
- Both the structured academic program and all of the clinical competencies MUST be satisfactory completed BEFORE requesting to take the ARRT LXMO exam.
- Upon completing all prerequisites and signing the Completion Agreement, an applicant may request the ARRT LXMO exam. (ARRT will decide if requirements and qualifications have been met.)
- If met, NDMIRTB forwards application to ARRT.
- Fees are payable directly to ARRT.
- ARRT contacts the applicant with a 90-day window to take the exam.
- Exam results are sent to NDMIRTB.
- NDMIRTB contacts applicant of pass/fail. If successfully passed, they will receive full licensure as a ND LXMO.
NDMIRT Board approved structured academic programs:
Note: The Board does NOT advocate one program over another and does NOT have any affiliations with any programs.
All program questions and pending dates of upcoming programs should be directed to the specific program.
Proof of completion MUST come directly from the program coordinator.
1) Continuing Education Providers
Address: PO Box 332 Powell, OH 43065
Phone Number: 614-342-0624
Contact: Stacey Melick, RT (R), Education Director
Email: continuingedproviders@gmail.com
Website: ceprovide.com click on Learn More: ND LXMO
2) control the dose Limited X-Ray
*Please note the only course with ND approval is the "COMPREHENSIVE Limited Operator Radiography Bundle"
Phone Number: +1(800) 687-1897
Website: Home - Control The Dose
3) Minnesota State Community and Technical College
Address: 900 MN-34 Detroit Lakes, MN 56501
Phone Number: 218-846-3740 - Detroit Lakes Campus
Website: https://www.minnesota.edu/programs-and-degrees/limited-scope-radiography
4) Dakota County Technical College
Address: 1300 -145th Street E Rosemount, MN 55068
Phone Number: 651-423-8549 - Continuing Education Department
Website: https://mnscu.rschooltoday.com/public/getsubcategory/category_id/23/program_id/5
Clinical Competency Requirements
Competence in clinical practice for the LXMO encompasses attributes of knowledge, problem solving, technical skills, comprehension, attitudes, and ethics. Please review the LXMO Clinical Competency Information Packet located at the bottom of the section and the additional information provided below carefully.
Upon satisfactory completion of the structured academic program, the applicant should begin their practical Clinical Competency requirements in a timely manner. Clinical Competency requirements MUST be completed within nine (9) months. As of March 2023, the Board has increased the time frame from six (6) months to nine (9) months. If there is valid evidence of a hardship completing the clinical requirements within 9 months the Conditional LXMO must contact the board office immediately with written explanations.
Overview of Clinical Competency Requirements
- After satisfactory completion of the structured academic program (copies of proof must be submitted to the Board office), you will need to apply and be issued a Conditional LXMO ND License and begin completing the LXMO Clinical Competency Information Packet. You must have a conditional LXMO license first to begin your clinical competency requirements.
- Clinical Competency requirements MUST be completed within nine (9) months. If there is valid evidence of a hardship completing the clinical requirements within 9 months, the Conditional LXMO must contact the board office immediately with written explanation(s).
- There is a total of 97 evals and final competencies to be completed by the Conditional LXMO. If needed, simulations are allowed, but every effort must be made to have patient interactions and NOT simulate. For the clinical evals #1-3, etc.; the majority of these must be performed on actual patients and NOT simulated on the more common procedures/exams. (If a vast majority of these are simulated your submission may be rejected, requiring you to acquire more patient interactions and fewer simulations.) Please refer to the Clinical Competency Infomation Packet for full details.
- The Conditional LXMO may perform procedures/examinations only while under personal supervision by a ND licensed ARRT Registered Radiographer or a ND licensed currently practicing LXMO with three (3) years of experience. (Personal supervision means: must be in attendance in the room during the performance of the procedure/examination.)
- The Conditional LXMO may obtain their clinical competencies at more than one facility if they choose, simply document each on the form provided in the information packet, locations of clinicals must be provided to the Board.
With (9) nine months to complete all clinical competency requirements, it is encouraged to make arrangements at a larger facility with a higher volume of procedures/examinations if you are employed at a smaller facility with a low volume of procedures/examinations. Please do not have more than one individual performing clinicals at a time per facility, especially if a low volume facility. This is not a requirement from the Board, only encouragement to assist with your success of completion and compliance of the clinical competency requirements.
- The Conditional LXMO may ONLY perform procedures/examinations independently (not under personal supervision) after successfully completing the required evaluations and final for that particular procedure/examination.
- After successful completion of the Clinical Competency Requirements, submit the list of your exams with the completed and signed Completion Agreement (last page of LXMO Clinical Competency Information Packet) and send it to Board office.
- Lastly, the Conditional LXMO notifies the Board office, in writing, requesting to take the ARRT LXMO exam.
- Upon completion of all prerequisites, ARRT decides if requirements and qualifications are met.
- If met, NDMIRTB forwards application to the ARRT.
- Fees are payable directly to ARRT for the LXMO examination (not the NDMIRTB).
- ARRT contacts the applicant with a 90-day window to take the exam. Exam results are sent to NDMIRTB.
- Required exam modules for medical clinics and hospital settings: Core, Chest, Extremities, Skull/Sinus, and Spine.
- NDMIRTB contacts applicant of pass/fail. If successfully passed, will receive full licensure as a ND LXMO.
ARRT State Licensing Exam
ATTENTION: Taking the ARRT state exam limits the applicant to practice within North Dakota and does not qualify the applicant to hold the ARRT national certification. The NDMIRTB State Licensing Examination may not transfer to other states.
The North Dakota Medical Imaging and Radiation Therapy Board (NDMIRTB) has a contract with the American Registry of Radiologic Technologists (ARRT) to administer the ARRT Examination to individuals who meet the minimum standards.
Check out the ARRT Website for state licensing handbooks and exam content documents, https://www.arrt.org/pages/resources/state-licensing/state-licensing-handbooks.
Applicants for a North Dakota State Licensing Examination MUST comply with the standards detailed by NDMIRTB and complete the appropriate forms along with the appropriate fee to apply for eligibility to take the ND State Licensing Examination administered by the ARRT.
Fees
Payable directly to ARRT online (not the NDMIRTB) for ARRT state LXMO examination (instructions supplied after eligibility).
*If you intend to apply for the ARRT national certification please contact the ARRT directly. Completing the NDMIRTB State Licensing Examination limits the applicant to practice within North Dakota and does not qualify the applicant to hold the ARRT national certification. The NDMIRTB State Licensing Examination may not transfer to other states.
You are NOT able to perform imaging on humans without a ND License. (Note: you MUST have completed ALL prerequisite requirements: didactic and clinical competency experience before requesting the ND State Examination.)
Application is valid for two years and maybe extended once or upon Board approval. (Must provide documentation to extend.)
Renewal and Continuing Education
All LXMOs renew by December 31 of the odd-numbered year. After renewal, the license will be good for 2 years. In the future, upon each biennial (2 year) LXMO renewal cycle, the NDMIRTB LXMO MUST submit all RCEEM approved continuing education. To renew, the LXMO must submit twelve (12) CE hours per licensure biennium.
Continuing Education requirements (per NDAC 114-02-01-02): Biennially shall complete twelve (12) hours of continuing education.
NDMIRTB LXMO Scope of Practice
Limited x-ray machine operators are limited in scope of practice to only those procedures approved by the board while under the general supervision by a licensed practitioner.
APPENDIX A
Practice Standards Related to Limited X-Ray Machine Operators
Limited x-ray machine operators are limited in scope of practice to only those procedures approved by the board. Limited x-ray machine operators may not perform fluoroscopic procedures or administer contrast media or radiopharmaceuticals. Specific procedures or examinations that are allowed in the scope of practice for limited x-ray machine operators include the following:
- Chest: PA, lateral, decubitus
- Ribs: AP, PA, obliques
- Abdomen: KUB, upright abdomen
- Hand and fingers: PA, lateral, oblique
- Wrist: PA, lateral, oblique
- Forearm: AP, lateral
- Elbow: AP, lateral
- Humerus: AP, lateral
- Shoulder: AP, internal and external rotation, y-view
- Clavicle: AP, AP axial
- Pelvis: AP
- Hips: AP, frog leg lateral, cross-table lateral
- Femur: AP, lateral
- Knee: AP, lateral, obliques
- Patella: AP, lateral, sunrise
- Tibia-fibula: AP, lateral
- Ankle: AP, lateral, obliques
- Calcaneus: Plantodorsal, lateral
- Foot and toes: AP, lateral, obliques
- Sinuses: Water's, lateral
- Skull: AP/PA, lateral
- Facial bones: PA, lateral
- Nasal bones: Water's, lateral
- C-spine: AP, lateral, odontoid, (not trauma), swimmer's (not trauma)
- T-spine: AP, lateral, swimmer's (not trauma)
- L-spine: AP, lateral, L5-S1 lateral
Any other procedure or examination performed during an emergency and requiring a limited x-ray machine operator to perform requires a written order from a licensed practitioner with personal supervision.
Licensees may petition the board to perform procedures and examinations not currently identified above. One of the criterion utilized by the board includes frequency of performance to consider approval or justification of expansion of the procedures and examination outlined above. *Petitions must be made before beginning to performing procedures and examinations outside of the limited scope.
Chiropratic Restricted LXMO
This information is for Chiropractic settings only. The restricted limited x-ray machine operator (LXMO) MUST be a ND licensed in good standing certified clinical chiropractic assistant (CCCA) with a restricted scope of practice working in a chiropractic setting only.
The restricted LXMO CCCA must already be licensed and in good standing by the ND Chiropractic Board of Examiners. The LXMO CCCA must complete a ND Medical Imaging and Radiation Therapy (NDMIRT) Board approved didactic LXMO program prior to submitting an application. Please refer to the Academic Programs tab for more information.
Upon submitting a certificate of completion of a board approved didactic program and an application to practice as a Conditional restricted LXMO CCCA in a chiropratic setting, a conditional restricted LXMO license will be issued allowing the clinical competency requirement to begin. The clinical competency is a mandatory process that must be followed as outlined by the NDMIRT Board. Precepting chiropractor MUST complete a notarized Letter of Attestation, this is a mandatory requirement of the application process.
Clinical Competency Requirements
The clinical competency requirements shall begin after issuance of the Conditional restricted LXMO license. The conditional restricted LXMO CCCA licensee may perform procedures/examinations only while under the personal supervision by a ND licensed chiropractor (in good-standing), a ND licensed ARRT radiographer or a ND licensed currently practicing LXMO with three (3) years of experience. Please refer to the ND Conditional restricted Limited X-ray Machine Operator Clinical Information Packet for more information.
Upon completion of the clinical competency requirements, which align with the restricted scope of practice, they must be approved by the NDMIRT Board. After approval, the conditional restricted LXMO CCCA licensee may request to apply for to take the State LXMO examination administered by the ARRT. Examination fees are payable directly to the ARRT. The required mandatory examinations modules: Core, Chest, Extremities and Spine. Please refer to the LXMO Exam tab for more information.
Restricted Scope of Practice for LXMO CCCA
The restricted Limited X-ray Machine Operator licensed and in good-standing certified clinical chiropractice assistant is RESTRICTED in scope of practice to only those procedures approved by the NDMIRT Board practicing in a chiropractic setting. Restricted LXMO CCCAs may not perform fluoroscopic procedures or administer contrast media or radiopharmaceuticals.
Specific procedures or examinations that are allowed in the restricted scope of practice for a ND restricted LXMO licensed CCCA include the following:
- Ribs: AP/PA, obliques
- Hand: PA, lateral, oblique
- Fingers: PA, lateral, oblique
- Wrist: PA, lateral, oblique
- Forearm: AP, lateral
- Elbow: AP, lateral
- Humerus: AP, lateral
- Shoulder: AP, internal and external rotation, y-view
- Pelvis: AP
- Hips: AP, frog leg lateral
- Femur: AP, lateral
- Knee: AP, lateral
- Tibia-fibula: AP, lateral
- Ankle: AP, lateral, oblique(s)
- Foot: AP, lateral, oblique(s)
- C-spine: AP, lateral, odontoid, (non-trauma),or possible swimmer's (non-trauma) *NO oblique views permitted
- T-spine: AP, lateral, or possible swimmer's (non-trauma)
- L-spine: AP, lateral, L5-S1 lateral *NO oblique views permitted
Any other procedures/examinations or views required and not part of the above RESTRICTED scope of practice of a ND restricted LXMO CCCA must be performed by the ND Licensed Chiropractor themselves.
Restricted LXMO CCCA Renewal & Continuing Education Requirements
You must renew your license with the online application and fees every two (2) years, to avoid expiration and additional fees. You MUST renew your license to continue to practice. It is illegal to practice without a current license.
Restricted limited x-ray machine operators (LXMOs) CCCAs must upload certificates of the earned continuing education. Those licensees must submit continuing education for every renewal. For the restricted LXMO CCCA tweleve (12) hours of CE must be within the current licensure cycle and be relevant to your practice as a restricted LXMO and not a CCCA. All documentation MUST be submitted upon each renewal. All CE must be RCEEM eligible. Additional information: See NDCC 43-62-14(7) and NDAC 114-02-01-10, 114-02-02-03.
