Appropriate Use Criteria for Ordering Advanced Imaging Tests

NextGen® Enterprise EHR Help

Create a Radiology Order Workflow

This procedure provides an overview of the basic steps to create a radiology order. When you create an order, you must complete all required fields that have been set up as Mandatory Data Points in File Maintenance Practice Preferences. These required fields display in red text. If you do not fill in a required field, when you try to save your information, a message appears, prompting you to complete the field. For more information on setting up Mandatory Data Point fields in File Maintenance Practice Preferences, go to NextGen Healthcare Success Community, and download the latest Orders Module Setup Guide for NextGen® Enterprise EHR. Open the Orders module. Select the Orders Summary tab. On the Top toolbar, select New > Lab Order. If an encounter with today's date exists, the Create New Lab Order window opens. If an encounter with today's date does not exist, a message appears, prompting you to create an encounter or use a selected encounter. After you associate an encounter with the

NextGen® Adaptive Content Engine Help Enterprise 8

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

If an advanced imaging order meets the appropriate use criteria (AUC), the My Custom Plan template saves the following information: the name of the qualified Clinical Decision Support Mechanism (CDSM) vendor, the ordering provider's National Provider Identification (NPI), the AUC score and the time the AUC was run, the reference number, the order date, and the G code and modifier. The captured information prints on the requisition document. If the advanced imaging order does not meet the AUC (for example, an AUC score of less than three), you can do the following: Accept the score and proceed. If the configuration for AUC certification is set up correctly, you cannot proceed without accepting the AUC score. If you cancel the score wizard, the order is not added to the pending orders grid and must be reordered. Cancel the current order and return to the My Custom Plan or Diagnostic Procedures template to reorder the identified advanced imaging test. Look at the other tests that are disp

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

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® Enterprise EHR Help

Select the Radiology Appropriate Use Criteria Threshold

Select the Radiology Appropriate Use Criteria Threshold Select the Radiology Appropriate Use Criteria Threshold Select File Maintenance > Master Files > System > EHR > Practices > Preferences > Orders Module. Select Lab/Rad tab. To change the AUC Rule Threshold value for your practice, select another Appropriate Use Criteria (AUC) Threshold from the list. The default value is 7. To save your changes, select OK. For more information about setting up the Radiology Appropriate Use Criteria (AUC), go to the NextGen Healthcare Success Community and download the latest Radiology Appropriate Use Criteria Workflow for the Orders Module forNextGen®Enterprise EHR Parent topic: Medical Necessity and Orders Practice Preferences Setup

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.

Appropriate Use Criteria for Ordering Advanced Imaging Tests

Recommendations

Create a Radiology Order Workflow

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

AUC Validation on Advanced Imaging Orders

Record AUC Data on Diagnostic Procedures

Select the Radiology Appropriate Use Criteria Threshold

Order Diagnostic Tests by AUC Score on My Custom Plan

Create a Radiology Order Workflow

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

AUC Validation on Advanced Imaging Orders

Record AUC Data on Diagnostic Procedures

Select the Radiology Appropriate Use Criteria Threshold

Order Diagnostic Tests by AUC Score on My Custom Plan