Updates to AIM advanced imaging clinical appropriateness guidelines

Beginning with dates of service on and after October 29, 2018, the following updates will apply to AIM Advanced Imaging Clinical Appropriateness Guidelines:                                                                                                                    

CT Chest guideline:

• Expanded list of diagnostic testing abnormalities that may be followed up with CT to include endoscopy, fluoroscopy, and ultrasound in addition to specific chest radiography findings
• Lengthening of timeframe required prior to imaging for chronic cough from 3 to 8 weeks, and more specifics of preliminary workup required prior to imaging
• Lower threshold for defining unexplained weight loss, and more explicit definition of preliminary workup required prior to imaging
• Allowance for use of imaging in the staging of malignancy prior to biopsy confirmation
• Allowance for imaging of suspected pulmonary embolism in pregnancy
• New criteria for appropriate imaging of chest wall mass

 

CT Angiography (CTA) Chest guideline:

• Allowance for imaging of suspected pulmonary embolism in pregnancy

 

CT Abdomen/CT Pelvis/CT Abdomen & Pelvis guideline:

• Lower threshold for defining unexplained weight loss, and more explicit definition of preliminary workup required prior to imaging

 

MRI Chest guideline:

• Inclusion of imaging of suspected pectoralis muscle tear
• New criteria for appropriate imaging of chest wall mass

 

MRI Abdomen guideline:

• Addition of hemochromatosis as an indication for imaging in pediatric patients

 

Ordering and servicing providers may submit prior authorization requests to AIM in 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 Web Portal at availity.com.
• Call the AIM Contact Center toll-free number: 866-714-1103, Monday–Friday, 8:00 a.m.–6:00 p.m. ET.

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 guidelines here.