Before you begin
- Ensure that you have configured Appropriate Use Criteria (AUC) in File Maintenance. For more information on how to configure AUC, go to NextGen Healthcare Success Community and download the latest Radiology Appropriate Use Criteria Workflow for the Orders Module for NextGen® Enterprise EHR.
- Ensure that you have selected the insurance information for the patient in the All tab.
Note: Computerized Physician Order Entry (CPOE) derives the insurance and diagnosis settings from the
Preferences configuration in
Practices in File Maintenance. For more information, go to
NextGen Healthcare Success Community and download the latest
File Maintenance Preferences Guide for NextGen® Enterprise.
- Ensure that you have completed the charge submission and payers information configurations in File Maintenance, which enables your practice to post charges for performing laboratory and diagnostic tests, and also to automatically include Healthcare Common Procedural Coding System (HCPCS) codes and Modifiers in the charges for diagnostic orders with Appropriate Use Criteria (AUC) check. For more information, go to NextGen Healthcare Success Community and download the latest File Maintenance Preferences Guide for NextGen® Enterprise.
When you select an advanced imaging order item, such as Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and Positron Emission Tomography (PET) scans, CPOE automatically calculates the appropriateness score of the image for the test based on the CPT® code, diagnosis, and the patient's age and gender information. You can review the appropriateness score and select the most appropriate test for the patient's medical condition.
- Open CPOE.
- Select an advanced imaging test to order.
- Assign a diagnosis to the order item.
The AUC score for the selected advanced imaging test and diagnosis appear in the
All and
Diagnostic tabs. The AUC score rating ranges between 1 and 9.
represents a score between 7 and 9. Indicates that the test is appropriate.
represents a score between 4 and 6. Indicates that the test may be appropriate.
represents a score between 1 and 3 score. Indicates that the test is not appropriate.
Note: If the diagnosis, CPT® code, and the patient's gender and age do not match, an AUC notification
appears.
- To view alternative recommended tests or to manually re-run the AUC check for the test, select the Diagnostic tab, and then select AUC Check under the Diagnostic Details section.
Note: You must manually run the AUC check whenever you select an alternative diagnosis or add insurance information for the selected test.
The AUC score wizard for the test opens, where you can select the appropriate indication and review the AUC score for the test.
- Select an appropriate CPT® code and select Accept.
