Updates to AIM Musculoskeletal Program Joint Surgery clinical appropriateness guidelines

As recently communicated in the February 2020 edition of Anthem’s Provider News, effective for dates of service on and after May 17, 2020, updates will apply to the AIM Musculoskeletal Program: Joint Surgery Clinical Appropriateness Guidelines.  These updates relate to the criteria in the following sections:

• Hip arthroplasty
• Knee arthroscopy and open procedures
• Shoulder arthroplasty including the removal of the  indication for subacromial impingement with rotator cuff tear  

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 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 and upcoming guidelines here.

 

438-0520-PN-GA