Updates to AIM Radiation Oncology Clinical Appropriateness Guidelines

Effective for dates of service on and after March 14, 2021, the following updates will apply to the AIM Radiation Oncology Clinical Appropriateness Guidelines.   

 

Radiation oncology

• Special treatment procedure
  • Removed IV requirement for chemotherapy

CNS cancer 

• IMRT for glioblastomas, other gliomas and metastases: Eliminated the 3D plan comparison requirement. Same change for high-grade and low-grade gliomas.
• IMRT for metastatic brain lesions: Added hippocampal sparing whole brain radiotherapy indication

Lung cancer 

• Eliminated the plan comparison requirement for IMRT to treat stage III non-small cell lung cancer.
• SBRT: Removed “due to a medical contraindication” language
• SBRT: Added “as an alternative to surgical resection” to stereotactic body radiation therapy
• Adjusted fractionation maximum for curative treatment of non-small cell lung cancer up to 35 treatments of thoracic radiotherapy.

 

Proton beam therapy

• Added new indication for hepatocellular carcinoma and intrahepatic cholangiocarcinoma

As a reminder, ordering and servicing providers may submit prior authorization requests to AIM in one of several ways:

• Access AIM’s ProviderPortal_SM 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 Web Portal at availity.com.
• Call AIM’s Contact Center toll-free number at 866-714-1107, Mon. - Fri., 8:00 a.m. - 5:00 p.m.

 

For questions related to guidelines, please contact AIM via email at aim.guidelines@aimspecialtyhealth.com.  Additionally, you may access and download a copy of the current and upcoming guidelines here.

 

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