What are appropriate use criteria (AUC) and why are we hearing about them now? According to the Centers for Medicare and Medicaid Services (CMS), AUC are “criteria that are evidence-based (to the extent feasible) and assist professionals who order and furnish applicable imaging services to make the most appropriate treatment decisions for a specific clinical condition.” ACEP has been working behind the scenes for the past two years in response to legislation which was passed in 2014. And yes, this is another burden that emergency physicians will have to shoulder beginning January 2018, when penalties (eg, Medicare payment denials) are scheduled to begin.
However, it may also have some benefit and help us care better for our patients.
The “Protecting Access to Medicare Act of 2014” (PAMA) included several provisions to slow the growth of Medicare costs, and one provision is AUC, where doctors ordering certain tests will be required to use clinical decision support (CDS) tools (eg, via embedded software in the electronic health record) for advanced imaging (defined as MRI, CT, nuclear medicine, and PET). Plain X-ray, fluoroscopy, and ultrasound exams are not currently included.| | | Next → | Single Page