Axea Solutions
  • Home
  • Services
    • Coding Audits and Reviews
    • Claims and Edit Remediation
    • Denials & Appeals Management
    • RCM Advisory
    • Coder Education and Training
    • Clinical Documentation Improvement
  • EDUCATION
  • TECHNOLOGY
  • About
    • Why Axea Solutions?
    • Leadership
    • Team
    • Axea in Action
    • Contact Us
  • News
  • Blog
  • Careers

Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging: 2020 Testing Period Officially Underway

1/22/2020

0 Comments

 
BY SUSAN GATEHOUSE, RHIT, CCS, CPC, AHIMA-APPROVED ICD-10/PCS TRAINER ​
Picture
The testing phase for the Appropriate Use Criteria (AUC) Program officially began January 1, 2020. Upon implementation of the program, physicians and other healthcare professionals who order an advanced diagnostic imaging test (MRI, CT, PET, and nuclear medicine; does not include X-rays, ultrasounds, or fluoroscopy services) must consult with AUC using a qualified decision support mechanism (CDSM). Professionals who provide these tests will be required to register the ordering professional’s consultation of AUC to be paid for the service. 
 
Providers will be required to use a qualified CDSM (certified as meeting Centers for Medicare & Medicaid Services/CMS requirements). If a provider does not follow AUC requirements and is discovered to have ordering patterns deemed as outliers, the law mandates that CMS require prior authorization. G-codes are needed for every advanced imaging service, and claims with multiple G-codes “shall be’’ accepted.
​Though 2020 is a testing period, and the program will not officially implement until January 1, 2021, this is a considerable change, and taking advantage of the testing period, while there is no impact on reimbursement, is crucial.
 
Axea’s CEO, Susan Gatehouse, took a deeper dive into the operational assessments required during this testing period, in a recently published article by ICD-10 Monitor-News.  In the article, Susan outlines the various processes to address in order to sufficiently prepare for the implementation of AUC, which will require the involvement of multiple departments, such as IT, radiology, physician, and health information management (HIM), just to name a few.
 
To access the complete article published by ICD-10 Monitor, Click Here. 
 
You can also LISTEN to Susan Gatehouse discuss AUC and report on the issue in the Talk-Ten-Tuesday broadcast from January 21 - Link Here to listen to the broadcast.
0 Comments



Leave a Reply.

    Archives

    April 2022
    February 2022
    December 2021
    May 2021
    April 2021
    March 2021
    February 2021
    December 2020
    November 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    October 2019
    September 2019
    August 2019
    May 2019
    January 2019

    Categories

    All

Axea Solutions, Inc. | 1400 Market Place Blvd., Suite 102 | Cumming, GA 30041 | info@axeasolutions.com | 855.424.4249
  • Home
  • Services
    • Coding Audits and Reviews
    • Claims and Edit Remediation
    • Denials & Appeals Management
    • RCM Advisory
    • Coder Education and Training
    • Clinical Documentation Improvement
  • EDUCATION
  • TECHNOLOGY
  • About
    • Why Axea Solutions?
    • Leadership
    • Team
    • Axea in Action
    • Contact Us
  • News
  • Blog
  • Careers