Take AUC testing year to see how well your reporting works — and how well docs take it

Subscribe or sign in to view the full article.

Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains the Medicare appropriate use criteria (AUC) testing year for advanced imaging and what it means for practices that order affected outpatient imaging services. It covers the CMS framework, clinical decision support mechanism reporting, vendor readiness, exemptions, internal preparation, and how organizations can use the testing period to evaluate workflow and provider response before the program carries enforcement consequences. The piece is aimed at physicians, administrators, radiology groups, and practice managers who need to understand the operational side of AUC compliance.

Why This Topic Matters

The testing year gives practices a chance to assess readiness before AUC reporting becomes more consequential. Understanding the program’s scope, workflow implications, and documentation requirements can help organizations avoid disruption and prepare for possible prior authorization triggers.

Article Sections

  1. AUC background and CMS timeline

    Introduces the Medicare appropriate use criteria framework for advanced imaging and summarizes the CMS implementation timeline. It also places the program in the context of federal policy and outpatient care settings.

  2. Clinical decision support and reporting requirements

    Explains the role of clinical decision support mechanisms in the ordering workflow and the need to document consultation results. It also describes the program’s reporting structure at a high level.

  3. Priority clinical areas and later consequences

    Outlines the clinical areas CMS is reviewing during the early program years and notes the potential downstream impact for providers whose patterns fall outside expected standards.

  4. Testing year and implementation preparation

    Describes the 2020 testing year and offers broad preparation themes for practices evaluating readiness. It focuses on workflow, vendor planning, and internal coordination.

  5. Run-up tips for AUC

    Summarizes practical preparation topics for organizations considering the transition. The section addresses applicability, tool selection, vendor status, provider communication, and planning for internal review.

What You Will Learn

  • How the AUC program fits into the Medicare imaging environment
  • What the testing year is intended to help practices evaluate
  • Which operational areas practices should review before full implementation
  • How organizations can think about vendor readiness and workflow integration
  • Why communication and internal monitoring matter during the transition

Who Should Read This

  • Physician practices
  • Radiology groups
  • Practice managers
  • Health information technology leaders
  • Compliance and revenue cycle staff
  • Medical group administrators

Codes Discussed

Modifiers Discussed


Subscribe or sign in to view the full article.

Official DecisionHealth® Newsletter Archives includes:

  • Includes over 25,000 articles from:
    • Coder Pink Sheets
    • Part B News
    • Answer Books newsletters
  • Current newsletters added each quarter
  • Timely news and guidance vital for your practice
  • Fully searchable through Find-A-Code's Comprehensive Search
  • Codes mentioned in articles are linked to the Find-A-Code Code Information pages
  • Code Information pages link back to related articles
  • Save yourself tons of research time, find everything in one place!
Access to this feature is available in the following products:
  • DecisionHealth Coding, Billing and Compliance Library

Related Articles

Articles are listed in order of calculated relevance.

demo
request yours today
subscribe
start today
newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.

Aimee- AI -powered coding assistant - Try it now for Free Would you like Aimee - AI
to help you with this?