AIM Speciality Health®

AIM Specialty Health, a separate company, is a nationally recognized leader delivering specialty benefits management on behalf of Anthem for certain health plan members. Determine if preapproval is needed for a Georgia Anthem member by visiting the “Medical Policy and Clinical UM Guidelines” page on our provider website or by calling the preapproval phone number printed on the back of the member’s ID card. To submit your request for any of the services below, contact AIM online via AIM’s ProviderPortal at aimspecialtyhealth.com/goweb. From the drop-down menu, select GA. You may also call AIM toll-free at 866-714-1103, Monday–Friday, 8:00 a.m.–6:00 p.m. ET

 

AIM provides benefits management for the programs listed below:

  • Imaging Level of Care
  • Genetic Testing
  • Diagnostic Imaging Management
  • Cardiovascular Services
  • Radiation Therapy Services
  • Outpatient Sleep Testing and Therapy Services
  • Cancer Care Quality Program
  • Musculoskeletal (for Fully Insured)
  • Upper Gastrointestinal Endoscopy


For more details on these programs, please visit the AIM Specialty Health® site at aimspecialtyhealth.com/marketing/guidelines/185/index.html. By clicking on the previous links, you will be directed to sites created and/or maintained by another, separate entity (“External Site”). Upon linking you are subject to the terms of use, privacy, copyright and security policies of the External Sites. We provide these links solely for your information and convenience. We encourage you to review the privacy practices of the External Sites. The information contained on the External Sites should not be interpreted as medical advice or treatment provided by us.

 

Eligibility and benefits

Eligibility and benefits can be verified by through anthem.com/provider or by calling the number on the back of the member’s identification card. Service preapproval is based on member’s benefit plan/eligibility at the time the service is reviewed/approved. Benefit plans vary widely and are subject to change based on the contract effective dates. The provider is responsible for verification of member eligibility and covered benefits. Except in the case of an emergency, failure to obtain preapproval prior to rendering the designated services listed below will result in denial of reimbursement.


Add to preappoval

MED.00134

Non-invasive Heart Failure and Arrhythmia Management and Monitoring System

0607T, 0608T

Add 2/1/2021

SURG.00156

Implanted Artificial Iris Devices

0616T, 0617T, 0618T, C1839

Add 2/1/2021

SURG.00157

Minimally Invasive Treatment of the Posterior Nasal Nerve to Treat Rhinitis

30999, 30117

Add 2/1/2021


Codes added to existing preapproval documents

MED.00103

Automated Evacuation of Meibomian Gland

0563T

Add 2/1/2021

SURG.00077

Uterine Fibroid Ablation: Laparoscopic, Percutaneous or Transcervical Image Guided Techniques

 

Previous title: Uterine Fibroid Ablation: Laparoscopic or Percutaneous Image Guided Techniques

0404T

Add 2/1/2021

SURG.00112

Implantation of Occipital, Supraorbital or Trigeminal Nerve Stimulation Devices (and Related Procedures)

 

Previous title: Occipital Nerve and Supraorbital Nerve Stimulation

61885, 64568, 64569, C1767, C1778

Add 2/1/2021

SURG.00129

Oral, Pharyngeal and Maxillofacial Surgical Treatment for Obstructive Sleep Apnea or Snoring

C1767, C1778, C1787, L8680, L8681, L8688

Add 2/1/2021

SURG.00011

Allogeneic, Xenographic, Synthetic and Composite Products for Wound Healing and Soft Tissue Grafting

Q4249, Q4250, Q4254, Q4255

Add 10/1/2020, New Code

OR-PR.00006

Powered Robotic Lower Body Exoskeleton Devices

K1007

Add 10/1/2020, New Code

GENE.00037

Genetic Testing for Macular Degeneration

0205U

Add 10/1/2020, New Code

CG-GENE-05

Genetic Testing for DMD Mutations (Duchenne or Becker Muscular Dystrophy)

0218U

Add 10/1/2020, New Code

CG-GENE-10

Chromosomal Microarray Analysis (CMA) for Developmental Delay, Autism Spectrum Disorder, Intellectual Disability (Intellectual Developmental Disorder) and Congenital Anomalies

0209U

Add 10/1/2020, New Code

GENE.00052

Whole Genome Sequencing, Whole Exome Sequencing, Gene Panels, and Molecular Profiling

0212U-0217U

Add 10/1/20-New Codes

 

CG-SURG-27

Gender Reassignment Surgery

54400, 54401, 54405, 55899, C1813, C2622, L8699

Add 9/01/2020



734-1120-PN-GA



Featured In:
November 2020 Anthem Provider News - Georgia