Updates to AIM Specialty Health Cardiac clinical appropriateness guidelines

Effective for dates of service on and after March 14, 2021, the following updates will apply to the AIM Specialty Health_®* (AIM) Advanced Imaging of the Heart and Diagnostic Coronary Angiography Clinical Appropriateness Guidelines.

 

Evaluation of patients with cardiac arrhythmias:

• Updated repeat transthoracic echocardiography (TTE) criteria.
• Added restrictions for patients whose initial echocardiogram shows no evidence of structural heart disease, and follow-up echocardiography is not appropriate for ongoing management of arrhythmia.

 

Evaluation of signs, symptoms or abnormal testing:

• Added restrictions for TTE in evaluation of palpitation and lightheadedness based on literature.

 

Diagnostic coronary angiography:

• Updated criteria to evaluate patients with suspected congenital coronary artery anomalies.

 

As a reminder, ordering and servicing providers may submit prior authorization requests to AIM Specialty Health^®* (AIM) in one of several ways:

• Access the AIM ProviderPortal_SM directly at aimspecialtyhealth.com/providerportal.
  • Online access is available 24/7 to process orders and is the fastest and most convenient way to request authorization.
• Access AIM via the Availity* Portal at availity.com.
• Call the AIM Contact Center toll-free number at 1-800-714-0040 from 7 a.m. to 7 p.m. CT

 

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.

 

* AIM Specialty Health is an independent company providing some utilization review services on behalf of Anthem Blue Cross and Blue Shield. Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield.

 

515374MUPENMUB