Update: Notice of changes to the AIM Small Joint Surgery Guideline
As indicated in our notice August 2020, effective November 1, 2020, AIM Specialty Health® (AIM) began administering the AIM Musculoskeletal program to perform medical necessity reviews for certain elective surgeries of the small joints using AIM clinical guidelines for Anthem Blue Cross (Anthem) fully insured members and some ASO groups.
Effective March 14, 2021, the AIM Small Joint Surgery Guideline has been updated with the following:
- Clarified requirements for imaging reports.
- Removed radiographic requirement for confirmation of lesser toe deformities.
- Ankle arthrodesis and total ankle arthroplasty added as new indications for revision of failed previous reconstructions.
- Removed total ankle arthroplasty requirements for adjacent joint or inflammatory arthritis.
- Clarified contraindications only apply to total ankle arthroplasty.
Providers should continue to submit prior authorization review requests to AIM using one of the following ways:
- Access AIM ProviderPortalSM directly at providerportal.com. Online access is available 24/7 to process orders in real-time and is the fastest and most convenient way to request authorization.
- Access AIM via the Availity Portal at availity.com
- Call the AIM toll-free number at 1-877-291-0360Monday through Friday 7:00 am – 5:00 pm PT.
For questions, please contact the provider number on the back of the member ID card.
March 2021 Anthem Blue Cross Provider News - California