Policy Updates Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialDecember 30, 2022

Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List

As previously communicated in the December 2022 edition of Provider News, AIM Specialty Health® (AIM)* will apply additional code updates to the AIM Diagnostic Coronary Angiography and Percutaneous Coronary Intervention Clinical Appropriateness Guidelines. That code update expansion has been delayed. The codes listed below will go into effect April 1, 2023, not February 1, 2023, as originally communicated. 

Percutaneous coronary intervention:

CPT code

Description

92975

Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography

C1714

Catheter, transluminal atherectomy, directional

C1724

Catheter, transluminal atherectomy, rotational

C1725

Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)

C1753

Catheter, intravascular ultrasound

C1760

Closure device, vascular (implantable/insertable)

C1761

Catheter, transluminal intravascular lithotripsy, coronary

C1769

Guide wire

C1874

Stent, coated/covered, with delivery system

C1875

Stent, coated/covered, without delivery system

C1876

Stent, non-coated/non-covered, with delivery system

C1877

Stent, non-coated/non-covered, without delivery system

C1885

Catheter, transluminal angioplasty, laser

C1887

Catheter, guiding (may include infusion/perfusion capability)

C9600

Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch

C9601

Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)

C9602

Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch

C9603

Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)

C9604

Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel

C9605

Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (list separately in addition to code for primary procedure)

C9607

Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel

C9608

Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (list separately in addition to code for primary procedure)

  • 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.
  • Call the AIM Contact Center toll-free number at 800-714-0040, Monday through Friday, from 7 a.m. to 7 p.m. Central

If you have questions related to guidelines, contact AIM via email at aim.guidelines@aimspecialtyhealth.com. Additionally, you may access and download a copy of the current and upcoming guidelines here.

* AIM Specialty Health is an independent company providing some utilization review services on behalf of the health plan.

MULTI-BCBS-CM-015066-22-CPN14827

PUBLICATIONS: January 2023 Provider Newsletter - Maine