September 27, 2019 - On July 26, the Centers for Medicare and Medicaid Services (CMS) issued a notification to update the AUC program requirements. This includes new regulations for the reporting of G-Codes and Healthcare Common Procedure Coding System (HCPCS) modifiers on claims submitted for advanced diagnostic imaging tests.
CMS also announced the claims systems will be ready to receive the new codes in January 2020. Additionally, calendar year 2020 will be a voluntary educational and operational testing period for submissions — full program implementation is expected by January 1, 2021. To be paid, complete AUC coding information must be included on all advanced diagnostic claims.
In collaboration with NDSC, MEDITECH has been closely monitoring AUC developments and began an evaluation of the changes needed to support the announced claims requirements. Since customers are eager to implement the necessary changes, we’ll continue providing updates as we work with NDSC and CMS to fully understand the coding and best practice impacts of the new requirements.
Timelines will be established to ensure any new coding changes are available prior to the new values being required on claims by January 1, 2021.
Please email our Regulatory Mailbox.