Ero Health Logo

CMS Deadline: Diagnostic Test Requirements for Referring Providers

Effective January 1st, as a referring provider, the ONLY way your Medicare patients will be approved for diagnostic imaging tests is if you comply with the new imaging Clinical Decision Support (CDS) mandate. This is more work for you, but the ONLY way your patients can receive the diagnostic tests they need.

Don’t make the mistake of thinking that CDS only applies to those practices that are actually performing and billing for the Medicare diagnostic imaging tests. As the practice ordering the test, you must consult Medicare’s Clinical Decision Support Mechanism (CDSM) tool to determine if your order adheres to the new guidelines.

Failing to correctly include Appropriate Use Criteria (AUC) with your diagnostic test order will mean the test will most likely NOT be performed. Also, you don’t want to be identified as an outlier by Medicare, because that means that you’ll be required to get any diagnostic imaging test you order preauthorized (not a pleasant thought).

To help you navigate this new rule more effectively, expert Lee Williams, RHIA, CCS, CCDS, CPC, CPCO, CEMC, CHONC, CRC, is presenting a step-by-step online training on Wednesday, December 4th at 1pm ET.

Here are just a few of the practical Medicare CDSM tactics you’ll receive by attending this upcoming, 60-minute online training:

  • Halt confusion between “voluntary” and “mandatory” reporting time
  • Accurately retrieve what you need from Medicare’s CDSM online tool
  • Avoid EHR problems from getting you into trouble
  • Pin down diagnostic settings that these rules apply to
  • Determine if you fit the exception and are not required to participate
  • Record your diagnostic tests to ensure a MIPS credit
  • And so much more…

There is no doubt that radiology providers will feel the reimbursement pain if you don’t accurately utilize Medicare’s new CDSM tool and correctly report the Medicare diagnostic imaging tests you order. But it’s your patients that will ultimately pay. This means non-radiology providers MUST master this new tool to get their patients the care they need.

This new mandated program goes into effect on January 1, 2020. Don’t wait, register for this expert-led online training today.