The recipe for AUC yields improved quality, reduces unnecessary imaging, and lowers costs. The Protecting Access to Medicare Act of 2014 (Public Law 113-93) directed the Centers for Medicare & Medicaid Services (CMS) to establish a program to promote the use of appropriate use criteria (AUC) for advanced diagnostic imaging services. As a result, Medicare ...
In Coding
Jun 7th, 2018
New HCPCS Level II modifier reports advanced diagnostic imaging provided to Medicare patients. The Centers for Medicare & Medicaid Services (CMS) created a new modifier to report use of a clinical decision support mechanism (CDSM) prior to ordering an advanced diagnostic imaging service for a Medicare patient. Look to Recent CMS Guidance As detailed in ...
In CMS
Mar 29th, 2018
Within the next several years, providers will be required to observe appropriate use criteria (AUC) as a condition of payment when reporting certain services for Medicare beneficiaries. Coders will need to be aware of this development, as it will begin to affect claims coding as early as July 2018. As described by AAOS: Appropriate Use ...
In Billing
Nov 10th, 2017
The Centers for Medicare & Medicaid Services (CMS) has finalized 2018 payments and policies under the Medicare Physician Fee Schedule (MPFS). Most notable is the leniency in adopting federally-mandated policies. CMS Finalizes 2018 MPFS Payment and Policy Changes was last modified: November 10th, 2017 by Renee Dustman...
In CMS
Jul 17th, 2017
The Centers for Medicare & Medicaid Services (CMS) has a date in mind for implementing the Appropriate Use Criteria (AUC) program for advanced diagnostic imaging services. In the 2018 Medicare Physician Fee Schedule (MPFS) proposed rule, CMS proposes Jan. 1, 2019, as the date when ordering professionals would need to consult specified applicable AUC using a qualified clinician ...