Are you ready for the new Appropriate Use Criteria (AUC) requirements?
Section 218(b) of the Protecting Access to Medicare Act of 2014 amended Title XVIII of the Social Security Act to add section 1834(q) directing CMS to establish a program to promote the use of appropriate use criteria (AUC) for advanced diagnostic imaging services. Under this program, when an advanced imaging service is ordered for a Medicare beneficiary, the ordering professional will be required to consult a qualified Clinical Decision Support Mechanism (CDSM). A CDSM is an interactive, electronic tool for use by clinicians that communicates AUC information to the user and assists them in making the most appropriate treatment decision for a patient’s specific clinical condition during the patient’s workup. The CDSM will provide the ordering professional with a determination of whether that order adheres to AUC, does not adhere to AUC, or if there is no AUC applicable (for example, no AUC is available to address the patient’s clinical condition) in the CDSM consulted.
NOTICE: The EDUCATIONAL AND OPERATIONAL RESTING PERIOD for AUC Program has been extended through CY 2021. There are no payment consequences associated with the AUC Program during CY 2020 and CY 2021. CMS encourage stakeholders to use this period to learn, test and prepare for the AUC program.
PENRAD Imaging is your best local source of information. Please call our Provider Relations team at (719) 265-3761 for assistance or consult the helpful links below.
Clinical Decision Support Mechanism (CDSM) recommended by the American College of Radiology:
https://qcdsm.nationaldecisionsupport.com/
For information on the new requirement:
MSN HealthCare Solutions webinar:
https://register.gotowebinar.com/recording/8038371583258671879
