Update to AIM Advanced Imaging of the Heart Clinical Appropriateness Guideline

Effective for dates of service on and after June 29, 2019, the following updates will apply to the AIM Clinical Appropriateness Guidelines for Advanced Imaging of the Heart and AIM Clinical Appropriateness Guidelines for Arterial Ultrasound. 

Advanced imaging of the heart

• Resting transthoracic echocardiography (TTE)
  • Changes made to address frequency of surveillance of LV function for cardio-oncology.

• TTE
  • Changes made to address frequency of surveillance echocardiography following transcatheter mitral valve repair. These recommendations follow the Centers for Medicare & Medicaid Services guidelines.

Arterial ultrasound

• Upper extremity arterial duplex
  • Indication added for creation of arteriovenous (AV) fistulae for dialysis
• Lower extremity arterial duplex
  • The American College of Cardiology (ACC) guideline for management of peripheral arterial disease (2016) indicates that duplex imaging should be performed only after the decision to revascularize has been made. There is no role for duplex imaging in the initial diagnosis of peripheral arterial disease. The current AIM guideline is not aligned with this position and the proposed changes address that malalignment.
  • Language changed to account for the fact that critical limb ischemia should include patients with non-healing ulcers and gangrene

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: 866-714-1107, Monday – Friday, 8:00 a.m. – 5:00 p.m.

 

Please note, this program does not apply to the Federal Employee Program® (FEP®), Taft-Hartley and BlueCard® Plans and programs.

 

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.