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Clinical Decision Support

The Protecting Access to Medicare Act (PAMA) requires referring providers to consult Appropriate Use Criteria (AUC) before ordering advanced diagnostic imaging services such as CT, MR, Nuclear Medicine and PET - for Medicare patients.

The AUC program mandates that when ordering advanced imaging services, the referring provider must consult a Clinical Decision Support Mechanism (CDSM). The referring provider must provide the appropriate documentation to the imaging facility so that the AUC consultation information is reported on the Medicare claim.

The implementation date for Clinical Decision Support (CDS) is January 1, 2023, however, the Centers for Medicare and Medicaid Services has implemented a test period for the remainder of 2022.

Referring providers that order advanced diagnostic imaging services for Medicare patients must use a qualified Clinical Decision Support Mechanism (CDSM) to consult AUC. Atlantic Medical Imaging has partnered with Cranberry Peak (G1008) to provide referring physicians access to ezCDS, an interactive, easy to use CSM.

ezCDS will:

  1. Check appropriateness for an imaging study and assign a modifier.
  2. Identify the appropriate imaging study based on the indications you provide.

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