General

General Question for the Week of December 2, 2019

General Compliance Question of the Week

Question:

What is the AUC?

Answer:

AUC stands for Appropriate Use Criteria and is part of the required provisions of PAMA, the Protecting Access to Medicare Act. Starting in 2020, radiologists will be required to consult AUC through a qualified clinical decision support mechanism (CDSM). Additionally, this consulted information must be provided to furnishing professionals and facilities. These furnishing entities are required to report the AUC consultation information on their Medicare claims. The program mandates that when a practitioner orders an advanced diagnostic imaging service for a Medicare beneficiary, he/she, or clinical staff acting under his/her direction, must consult a qualified a CDMS. AUC is accessed through these CDMS electronic portals. Providers have the ability to access imaging AUC through a stand-alone CDS system or using CDS software incorporated into their electronic health record system.


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