Georgia Anthem preapproval list change notification 4/1/2022

AIM Specialty 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 prior authorization 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 prior authorization 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 website 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
• Rehabilitative services
• Outpatient sleep testing and therapy services
• Cancer care quality program
• Musculoskeletal (for fully insured)
• Upper gastrointestinal endoscopy in adults, and site of care for certain surgical services

For more details on these programs, please visit the AIM website. Clicking the previous links will direct you 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

Verify eligibility and benefits on anthem.com/provider or by logging onto Availity.com. From the Patient Registration tab, run an Eligibility and Benefits Inquiry. 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 preapproval
LAB.00043 Immune Biomarker Tests for Cancer	0216U	Add 07/01/2022
LAB.00045 Selected Tests for the Evaluation and Management of Infertility	89329, 89330, 0253U, 0255U 86357	Add 07/01/2022
RAD.00067 Quantitative Ultrasound for Tissue Characterization	0689T, 0690T	Add 07/01/2022
SURG.00160 Implanted Port Delivery Systems to Treat Ocular Disease	67028	Add 7/01/2022
SURG.00154 Microsurgical Procedures for the Prevention or Treatment of Lymphedema	15756, 49906	Add 7/01/2022
LAB.00015 Detection of Circulating Tumor Cells	0317U	Add 4/1/2022 (New Code)
GENE.00023 Gene Expression Profiling of Melanomas	0314U	Add 4/1/2022 (New Code)
GENE.00049 Circulating Tumor DNA Panel Testing (Liquid Biopsy)	0306U, 0307U	Add 4/1/2022 (New Code)
LAB.00036 Multiplex Autoantigen Microarray Testing for Systemic Lupus Erythematosus	0312U	Add 4/1/2022 (New Code)

 

1371-0422-PN-GA