Appropriate Use Criteria: Understanding the Requirements and Impact

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Appropriate Use Criteria: Understanding the Requirements and Impact

Product Code: YHHA043020A

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Appropriate Use Criteria: Understanding the Requirements and Impact

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Presented on:
Thursday, April 30, 2020 | 1:00–2:30 p.m. Eastern

Presented by: Denise Williams, COC, CHRI

CMS’ Appropriate Use Criteria (AUC) program for advanced diagnostic imaging is in full swing—but does your organization know how to navigate reporting AUCs across provider types and places of service? With a one-year education and testing period in progress, organizations only have a few months left to get it right before financial penalties hit in 2021. And the potential costs aren’t just financial: Ordering practitioners who consistently fail to follow the rules will be subject to mandatory prior authorization for advanced diagnostic imaging.

During this 90-minute webinar, expert speaker Denise Williams, COC, CHRI, will discuss AUC reporting requirements, how to access the criteria, processes to support reporting, and how to ensure that all information is available and reported on the claim. Williams will also cover the use of HCPCS G-codes and modifiers to represent the specific clinical decision support mechanism and AUC consulted, as well as how to implement changes and improvements to your AUC process. Audience members will be able to ask questions during a live Q&A session at the end of the presentation.

At the conclusion of this program, participants will be able to:

  • Define the appropriate use of advanced diagnostic imaging
  • Understand the meaning of Appropriate Use Criteria (AUC)
  • Identify the AUC priority clinical areas
  • Understand billing requirements
  • Recognize provider operational considerations

Agenda

  • What is the Appropriate Use Criteria (AUC) program?
    • Defining AUCs and advanced diagnostic imaging
    • Applying AUCs
    • Services excluded from AUC requirements
      • Emergency medical conditions
    • Understanding the goals of the program
  • Timeline of key provisions
    • Key conclusions of demonstrations
    • Provider-led entities
    • Clinical decision support mechanisms
    • Analyzing the process relationship
    • Priority clinical areas
  • Reporting AUCs
    • Understanding the reporting process
    • G-codes and modifiers finalized in the 2020 Medicare Physician Fee Schedule
    • AUC timeline
      • Education and operations testing period
      • Full implementation
    • Operational considerations
  • Q&A

Meet the Speakers

Denise Williams

      

Denise Williams, COC, CHRI, is senior vice president of the revenue integrity division and compliance auditor at Revant Solutions, Inc. She has more than 30 years of healthcare experience, including a background in multiple areas of nursing. For the past 25 years, Williams has been in the field of coding and reimbursement and has performed numerous E/M, OP surgical, ED, and observation coding chart reviews from the documentation, compliance, and reimbursement perspectives. She serves as a contributing author to articles published in HCPro’s Briefings on APCs and is a nationally recognized speaker on various coding and reimbursement topics. Williams serves as an advisory board member for NAHRI.

Instructions

Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: 56K or faster Internet connection (high-speed connection recommended) 
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices 

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

CAN'T LISTEN LIVE? 
No problem. The On-Demand version will be available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $259 value! 

PLEASE NOTE 
Participation in the webinar is just $259 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email customerservice@hcpro.com if you have questions.