Appropriate Use Criteria (AUC) Validation on an Advanced Imaging Order

NextGen® Adaptive Content Engine Help Enterprise 8

Configure AUC Scores

Configure AUC Scores Configure AUC Scores You must configure settings in File Maintenance and on the Practice Configuration practice template to use the AUC score wizard. To successfully use the AUC score wizard, you must configure the following settings in File Maintenance. Open NextGen® Enterprise EHR. To activate the AUC rules for the assigned payer, in the File Maintenance, do the following. In the Master Files, click Payers. The Payers List window opens. Double click a payer from the list. The Modify Payer Information window for the payer opens. Click the Orders Module tab, and select the Enable payer for Appropriate Use Criteria rules for Advanced Radiology Imaging orders check box. Apply the AUC for all payers within the same financial class, if necessary. To automate the inclusion of modifier and G-code in the procedure billing, select the Include AUC /HCPCS code modifier automatically option. Select a payer in the encounter level insurance for the current patient. In the Order

NextGen® Adaptive Content Engine Help Enterprise 8

Order Diagnostic Tests by AUC Score on My Custom Plan

If appropriate use criteria (AUC) has been configured and the orders meet the AUC criteria, you can generate an AUC score for an advanced imaging test on the My Custom Plan template. From the My Custom Plan template, in the My Plan panel, select an assessment. From the Order Options section, click Diagnostics, and then select an advanced imaging test from the list. Note: If you change the patient's insurance carrier or other payer details, you must reorder the radiology tests after modification. My Plan The AUC Score Wizard opens. From AUC Score Wizard, select check boxes for exam indications and then click Review AUC. Review AUC Review the AUC score for the ordered test and other associated CPT codes. To select a different test from the wizard, select the CPT code. Review AUC Click Accept. The selected test and its AUC score appears as messages on the My Custom Plan template. The advanced imaging order with the accepted AUC score is added to the Pending Orders grid. Click Place Order.

NextGen® Adaptive Content Engine Help Enterprise 8

AUC Validation on Advanced Imaging Orders

The AUC score is used to validate the appropriateness of an Advanced Imaging order. You can initiate the American College of Radiology (ACR) Appropriate Use Criteria (AUC) score wizard from the Assessment And Plan or Procedure Order cardiology templates by selecting a radiology order or cardiology procedure such as a CT, MRI, PET, Echo, or ECG. The AUC wizard displays the AUC score, which indicates whether the selected order is the most appropriate imaging test for a specific clinical condition or not. You can either accept or cancel the AUC score. If you accept the AUC score, the Assessment And Plan or the Procedure Order template records the AUC score and prints it on the requisition document. After the order is placed, the AUC score label no longer appears on the Assessment And Plan and Procedure Order cardiology templates. The AUC information may be shared as order details when the cardiology procedure or radiology order is processed by a third party. For more information on the AU

NextGen® Adaptive Content Engine Help Enterprise 8

Order Diagnostics Tests by AUC Score on My Plan

From the My Plan template, in the Today's Assessments section, select an assessment. From the Diagnostics section, click the blue arrow, and then select a diagnostic test to add. You can add up to six diagnostic tests in the Diagnostics section. My Plan To run the AUC check, select a diagnostic test. Note: If you have added multiple diagnostic tests, you must run the AUC check for each test individually. Review AUC From the AUC Score Wizard, select check boxes for exam indications and then click Review AUC. Review the AUC score for the selected test and other associated CPT codes. To select a different test from the wizard, select the associated CPT code. Review AUC Click Accept. Note: To view the AUC score of a test, mouse-over the appropriate diagnostic test. The tooltip displays the AUC score. AUC Score From the My Plan template, in the Diagnostics section, select one or more diagnostic tests. You can view AUC score of a test by hovering your mouse over the test. Click Place Order.

NextGen® Adaptive Content Engine Help Enterprise 8

Record AUC Data on Diagnostic Procedures

The Diagnostics tab supports AUC verification. If the patient's insurance carrier or other payer details change, you must re-order the radiology tests after the payer modification is documented. On the Diagnostic tab, highlight an assessment and click the Radiology navigational link. Select an advanced radiology order (for example, a CT brain w/o contrast). Click OKto close the list and automatically open the AUC score window. Select the appropriate indications and click Review AUC. Do one of the following actions: Click Acceptto close the window. The order details display in the Diagnostic Procedures template. Click Cancelto decline the AUC score. Cancel closes the AUC score window, no details are captured, and the order is not added to pending orders for the encounter. For all accepted orders, click Place Order to view the advanced imaging order under Diagnostic studies ordered today. For more information on the AUC score window and how it interacts with the Orders module, go to Next

NextGen® Adaptive Content Engine Help Enterprise 8

Order Diagnostic Tests by AUC Score

You can generate the Appropriate Use Criteria (AUC) for diagnostic tests. Before you begin You must configure the AUC in File Maintenance and map them in the Care Guidelines Setup practice template for a patient to generate an AUC score for an advanced imaging test and then place the appropriate order. In the Practice Configuration practice template, you must ensure that the Enable Appropriate Use Criteria (AUC) Rules check box is selected and the Enable Order Module check box is not selected. Open NextGen® Enterprise EHR. On a patient encounter, open any of the standard visit templates (for example, the Intake) template. On the template header, select the Care Guidelines link. The Care Guidelines Paged View template opens. In the Care Guidelines grid, select a diagnostic test. The AUC Score Wizard opens. Select the check boxes for exam indications and then select Review AUC. AUC Score Wizard The AUC Score Wizard displays the AUC score for the selected test. Review the AUC score genera

Appropriate Use Criteria (AUC) Validation on an Advanced Imaging Order

Recommendations

Configure AUC Scores

Order Diagnostic Tests by AUC Score on My Custom Plan

AUC Validation on Advanced Imaging Orders

Order Diagnostics Tests by AUC Score on My Plan

Record AUC Data on Diagnostic Procedures

Order Diagnostic Tests by AUC Score

Appropriate Use Criteria (AUC) Validation on an Advanced Imaging Order

Configure AUC Scores

Order Diagnostic Tests by AUC Score on My Custom Plan

AUC Validation on Advanced Imaging Orders

Order Diagnostics Tests by AUC Score on My Plan

Record AUC Data on Diagnostic Procedures

Order Diagnostic Tests by AUC Score