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 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: 800-554-0580, Monday – Friday, 8:30 a.m. – 7:00 p.m. Eastern time.

 

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.

 

802-1220-PN-CNT



Featured In:
December 2020 Anthem Provider News - Kentucky