When reporting for appropriate use criteria in the future, what must be included in the claims?


Overall, note that claims for advanced diagnostic imaging services must include:

  • The ordering professional’s national provider identifier (NPI)
  • Which CDSM was consulted among the multiple qualified CDSMs available
  • Identifying if the service ordered would or would not adhere to consulted AUC or if the consulted AUC was designated as not applicable to the ordered service.

This question was answered in our Nuclear Medicine & PET Coder. For more hot topics relating to radiology services, please visit our store or call us at 1.800.252.1578, ext. 2.


CPT® copyright 2021 American Medical Association (AMA). All rights reserved.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

CPT is a registered trademark of the American Medical Association.