Why Move to Version 3.x?

As breast imaging technology and processes evolve, new data become valuable for understanding individual practice performance.  With the guidance of NMD Committee members, new data fields are added to the registry that reflect changing practice.  

NMD participating practices are encouraged to transition to the latest version to obtain the most benefit from registry participation and to contribute data so that national performance benchmarks can be established.

As of December 31, 2022, versions 2.0, 2.2, 3.0 and 3.4 are the only versions supported at this time.

Additional Data Fields Available in 3.x

NMD Version 3.x has many additional data fields, some of which are explained below.  View the complete list here. For further explanations, see the NMD Data Dictionary.

  • Laterality of audit exam:  allows reporting data at either the breast level or patient level. If you are using NMD-certified software, you configure this option when you first start using Version 3.x.

Note: Do not change this frequently because then your audit results will be derived from a mix of breast- and patient-level data.

  • Combination examination: enables reporting data at either the component level or the combination level. For example, for a combination exam consisting of a mammogram and an ultrasound, you can assign a different assessment to the mammogram and the ultrasound, or just one assessment for the combination exam.

Note: NMD defines a combination exam as two or three exams, or components, conducted on the same patient for the same indication on the same day using different modalities.

  • Second and third physician identifier: allows for up to three separate assessments for the same exam to audit assessments more accurately from double reads, using one of various methods described in the Follow up and Outcomes Monitoring section of the BI-RADS Atlas. 

Note: Assessments are used in calculating measures by physician. You still must report a single assessment for the entire exam for use in calculating measures by facility.

Both NMD Versions 2.2 and 3.4 include all the fields from 2.0 and 3.0, respectively, as well as the following fields: 

  • Facility ID

  • Old Medicare Beneficiary ID

  • New Medicare Beneficiary ID

  • Fields for reporting COVID information about the patient

Additionally, Version 3.4 includes a field for reporting method of cancer detection.


Getting Started with the Transition Process

Talk with your team about the benefits of transitioning to Version 3.x before starting the process. You can use version 3.0 or 3.4, but it is usually most beneficial to transition to the latest version.

The process varies from vendor to vendor, so it is important to obtain instructions from your vendor.

Software vendors go through a three-step certification process for 3.x. Upon completion of the first two steps, which involve sending files to ACR to demonstrate their software can populate NMD fields accurately, vendors are conditionally certified.  To complete their certification, and as a more robust test of their audit logic, vendors must provide an accurate audit. The list of certified and conditionally certified software vendors is on the NMD website.

Note: If your vendor does not offer a Version 3.x release, we encourage you to contact them about your interest in transitioning. Customer interest is a major factor in a vendor’s decision to commit resources to a new release.

Managing Previous Records Submitted Using Version 2.0/2.2 

The process for uploading a Version 3.x vs 2.x file is the same. You may use a Version 3.x file to update records that you have previously reported using Version 2.x. Though it is not necessary, we encourage you to re-upload your previous records in order to take advantage of the new fields in Version 3.x. All ultrasound and MRI data elements, and all other 3.x fields, are null for exams reported using 2.x formats. If the same exam is again reported using a 3.x format, the 3.x fields are populated. Fields common to both versions of NMD are overwritten. 

Note: Exams for the same patient are linked using Social Security Number, Old Medicare Beneficiary ID, New Medicare Beneficiary ID, and/or the unique patient ID you provide, regardless of the NMD version used to report the exam.


If you encounter difficulties in generating a Version 3.x file, contact your vendor. If the vendor needs help from ACR, please contact the NRDR help desk for support.

Please check your registration in the NRDR portal to confirm if your vendor information is still accurate. This will help us identify problem areas that may be specific to a certain vendor.