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 pre-service clinical review requests to AIM in one of the following 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: 866-714-1107, Monday – Friday, 8:00 a.m. – 5:00 p.m.

 

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.



Featured In:
August 2018 Anthem Maine Provider Newsletter