Feb 15, 2024 · CDSMs are electronic portals through which appropriate use criteria (AUC) is accessed. The CDSM provides a determination of whether the order adheres to AUC, or if the AUC consulted …

We finalized in the CY 2024 PFS final rule a pause to the AUC Program for reevaluation. We also rescinded the current AUC Program regulations at 42 CFR 414.94 and reserved this section of the …

Feb 20, 2020 · This article (SE20002) provides guidance for processing claims for certain institutional claims that are subject to the Appropriate Use Criteria (AUC) program for advanced diagnostic …

Dec 6, 2019 · CR11268 informs MACs that, effective on January 1, 2020 (the start of the AUC program Educational and Operations Testing Period), they should accept the Appropriate Use Criteria (AUC) …

Beginning in 2020, if you order Medicare Part B advanced diagnostic imaging services, you must consult appropriate use criteria (AUC) through a qualified Clinical Decision Support Mechanism (CDSM).

Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances.

SUBJECT: International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determinations (NCDs) and Update to the Appropriate Use Criteria (AUC) …

Q4: Is it appropriate to bill HCPCS code G2211 using the Primary Care Exception primary care exception for lower-level O/O E/M services provided by resident physicians in certain primary care …

A. Background: The purpose of this Change Request (CR) is to make contractors aware of policy updates for the Appropriate Use Criteria for Advanced Diagnostic Imaging (AUC) program resulting …

Feb 28, 2025 · There is an appropriate use for modifiers 59 or XE or XS that is applicable only to codes for which the unit of service is a measure of time (e.g., per 15 minutes, per hour).