Updates to AIM Sleep Disorder Management clinical appropriateness guideline
This communication applies to the Medicare Advantage and Medicare-Medicaid Plan (MMP) programs for Anthem Blue Cross (Anthem).
Effective for dates of service on and after August 16, 2020, the following updates will apply to the AIM Specialty Health®* (AIM) Sleep Disorder Management Clinical Appropriateness Guideline.
Sleep Disorder Management Clinical Appropriateness Guideline updates by section:
- Bi-Level Positive Airway Pressure (BPAP) Devices:
- Change in BPAP FiO2 from 45 to 52 mmHg based on strong evidence and alignment with Medicare requirements for use of BPAP
- Multiple Sleep Latency Testing and/or Maintenance of Wakefulness Testing:
- Style change for clarity
- Code changes: none
As a reminder, ordering and servicing providers may submit prior authorization (PA) requests to AIM by:
- Accessing AIM’s ProviderPortalSM directly at com. Online access is available 24/7 to process orders in real time, and is the fastest and most convenient way to request PA.
- Accessing AIM via the Availity Portal.*
- Calling the AIM Contact Center at 1-800-714-0040 from 5 a.m. to 5 p.m. PT.
What if I need assistance?
If you have questions related to AIM guidelines, email AIM at email@example.com. Additionally, you may access and download a copy of the current and upcoming guidelines here.
June 2020 Anthem Blue Cross Provider News - California