Advanced Imaging Services: Requirements to Ensure Eligibility for Reimbursement - On Demand Access
Advanced imaging services have received significant attention over the past 10 years. Providers of such services as CT scans are required to have specific accreditation in order to receive reimbursement. While these requirements have been in place for some time, beginning Jan. 1, 2022, another set of requirements will be implemented. Appropriate Use Criteria (AUC) was created by the Centers for Medicare and Medicaid Services (CMS) to ensure beneficiaries are receiving the most appropriate imaging service for their clinical situation. This 90-minute webinar will discuss requirements of both advanced imaging and AUC, correct code and modifier reporting as well as impacts to reimbursement.
At the conclusion of this program, participants should be able to:
- Define Advanced Imaging Accreditation and AUC.
- Differentiate between Advanced Imaging Accreditation and the AUC program.
- Describe the AUC program with identification of the data elements required on a claim.
- Identify which payers require accreditation and use of AUC.
- Explain additional operational processes that will be required for the individual provider to ensure compliance.
An Internet-based CDE/CME Activity
Original Release Date: November 10, 2021
Expiration Date: November 10, 2024
Estimated time to complete this educational activity: 1.5 hours
Method of participation: Self-Study
Denise Williams, COC, CHRI, has more than 35 years of healthcare experience with 25 years in the areas of revenue integrity and compliance. She is recognized as a leading authority in the areas of medical coding, revenue cycle and reimbursement, Medicare and third-party payer compliance as well as charge master coordination and maintenance. She has performed numerous audit assessments for facility and professional providers based on documentation, revenue cycle, compliance and reimbursement perspectives. Her areas of focus include outpatient surgery (all types), ancillary services, emergency department services and observation services. In addition, Ms. Williams is a leading expert on charge description masters and has assisted with reconstruction of charging structures and processes to ensure third-party payer compliance. She also is a recognized authority on CMS’s Outpatient Prospective Payment System, speaking for many specialty societies, nursing organizations, state hospital associations as well as facility and hospital systems. She has provided comment and testimony to the Hospital Outpatient Prospective Payment System panel regarding CMS policy and the operational impact to providers.
Relevant Conflict of Interest Disclosure: No Relevant Conflict of Interest Disclosures were reported.
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