ACR updates rules that guide doctors in ordering imaging exams
Appropriate use criteria will soon be required for Medicare reimbursement for some imaging procedures, says Frank Rybicki, MD.
The American College of Radiology has released the latest edition of its Appropriateness Criteria, which provides evidence-based guidance for radiologists on when imaging examinations are clinically warranted.
The ACR says the new release covers 233 topics—these include 176 diagnostic imaging and interventional radiology topics and 61 radiology oncology topics. In teasing out potential variations in these topics, the release covers 883 clinical variants covering 1,570 clinical scenarios. The guidelines are developed by expert panels of radiologists and other doctors from relevant medical specialties.
The Appropriateness Criteria are evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. Employing these guidelines helps providers enhance quality of care and contribute to the most efficacious use of radiology.
The ACR guidance is important because its guidelines are specified as appropriate use criteria under the Protecting Access to Medicare Act (PAMA), which establishes the Medicare Appropriate Use Criteria (AUC) Program for Advanced Diagnostic Imaging. The program, a form of clinical decision support, was established through PAMA, in which Congress included a mandate that providers consult appropriate use criteria via electronic clinical decision support systems when they order outpatient imaging exams for Medicare patients.
Also See: Digital pathology lags radiology in maturity but offers potential payoff
Providers who conduct the imaging studies must document that consultation in order to receive reimbursement. The ACR is one of several qualified provider-led entities that have developed criteria that doctors can consult before ordering advanced diagnostic imaging for Medicare patients.
The update from the American College of Radiology (ACR) includes one new and nine revised topics. Each topic has a narrative, an evidence table and a literature search summary. The new topic is on post-therapy imaging for lower extremity arterial revascularization.
“ACR appropriateness criteria are created and continually updated by multispecialty teams and widely accepted across the medical field as a national standard. Use of these evidence-based guidelines helps ensure that patients get the right care for their condition and avoid unnecessary care,” said Frank J. Rybicki, MD, chair of the ACR Committee on Appropriateness Criteria.
The ACR says the new release covers 233 topics—these include 176 diagnostic imaging and interventional radiology topics and 61 radiology oncology topics. In teasing out potential variations in these topics, the release covers 883 clinical variants covering 1,570 clinical scenarios. The guidelines are developed by expert panels of radiologists and other doctors from relevant medical specialties.
The Appropriateness Criteria are evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. Employing these guidelines helps providers enhance quality of care and contribute to the most efficacious use of radiology.
The ACR guidance is important because its guidelines are specified as appropriate use criteria under the Protecting Access to Medicare Act (PAMA), which establishes the Medicare Appropriate Use Criteria (AUC) Program for Advanced Diagnostic Imaging. The program, a form of clinical decision support, was established through PAMA, in which Congress included a mandate that providers consult appropriate use criteria via electronic clinical decision support systems when they order outpatient imaging exams for Medicare patients.
Also See: Digital pathology lags radiology in maturity but offers potential payoff
Providers who conduct the imaging studies must document that consultation in order to receive reimbursement. The ACR is one of several qualified provider-led entities that have developed criteria that doctors can consult before ordering advanced diagnostic imaging for Medicare patients.
The update from the American College of Radiology (ACR) includes one new and nine revised topics. Each topic has a narrative, an evidence table and a literature search summary. The new topic is on post-therapy imaging for lower extremity arterial revascularization.“ACR appropriateness criteria are created and continually updated by multispecialty teams and widely accepted across the medical field as a national standard. Use of these evidence-based guidelines helps ensure that patients get the right care for their condition and avoid unnecessary care,” said Frank J. Rybicki, MD, chair of the ACR Committee on Appropriateness Criteria.
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