Radiology Requisition Report

CDSM Vendor	AUC Modifier	Result
G1004	MF	The result has a score of 1-3 and is highlighted in red.
G1004	ME	The result has a score of 4-9 and is highlighted in green or yellow.
G1004	MG	Does not display any score.
G1004	MC	Displays an error and you cannot complete the AUC process.

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® Enterprise EHR Help

Appropriate Use Criteria for Ordering Advanced Imaging Tests

To meet the regulatory CMS mandate for Clinical Decision Support (CDS) when ordering radiology advanced imaging tests (such as CTs, MRIs, and PET scans), practices can set up and use Appropriate Use Criteria (AUC). After setting up the AUC in File Maintenance, providers or other clinical staff can order Advanced Imaging tests and receive appropriate use feedback for a patient’s medical condition before placing radiology orders from the Orders module. This process occurs immediately after the user selects the advanced imaging test on the Create New Radiology Order window. For detailed information on setting up and using Appropriate Use Criteria (AUC), go to the NextGen Healthcare Success Community, and download the Radiology Appropriate Use Criteria Workflow for the Orders Module for NextGen® Enterprise EHR. Parent topic: Create a Radiology Order Workflow

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® Orthopedic Suite Help 80.2.14.0

Review AUC Scores for Radiology Tests

If you changed a diagnosis code for a radiology test configured for Appropriate Use Criteria (AUC) in File Maintenance, you can review the AUC scores manually to ensure you have the appropriate AUC information. Open the Home or any other applicable template, select Orders from the upper navigation bar, and then select Single Order or Radiology Order. In the Radiology Order template or the Radiology panel of the Single Order template, select the appropriate test from the This Order grid. Select Run AUC. The AUC Score Wizard window opens displaying the AUC score for the selected test. Review the AUC score of the test. Optional: Select a different test from the grid. Note: NextGen Healthcare recommends that you select a test with the same category as the test you selected on the Single Order or Radiology Order template. Select Accept. If you select a different test, the original test in the Single Order or Radiology Order template is replaced with the test you selected, and the AUC values

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

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

Radiology Requisition Report

Recommendations

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

Appropriate Use Criteria for Ordering Advanced Imaging Tests

AUC Validation on Advanced Imaging Orders

Review AUC Scores for Radiology Tests

Record AUC Data on Diagnostic Procedures

Configure AUC Scores

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

Appropriate Use Criteria for Ordering Advanced Imaging Tests

AUC Validation on Advanced Imaging Orders

Review AUC Scores for Radiology Tests

Record AUC Data on Diagnostic Procedures

Configure AUC Scores