Reminder: Hospitals Billing for the Appropriate Use Criteria for Advanced Diagnostic Imaging

On 1/9/2020, CMS issued additional instructions in SE20002, Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging- Approval of Using the K3 Segment for Institutional Claims to provide additional information on MM11268 Revised, Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging – Educational and Operations Testing Period - Claims Processing Requirements. SE2002 includes instructions related to the use of the qualified Clinical Decision Support Mechanism (CDSM) G- codes (G1000–G1011). Each reported CDSM G-code must contain the following line of service information: date of related advanced diagnostic imaging service and a nominal charge, e.g., a penny for institutional claims. In addition, this article contains other instructions and includes UB04 claim examples. 

Posted 1/31/2020