Policy Updates Medical Policy & Clinical GuidelinesCommercialFebruary 28, 2021

Update: Notice of changes to the AIM Small Joint Surgery Guideline

As of November 1, 2020, AIM Specialty Health® (AIM) began administering the AIM Musculoskeletal program to perform medical necessity reviews for certain elective surgeries of the small joints using AIM clinical guidelines for Anthem Blue Cross fully insured members and some ASO groups.   

 

Effective March 14, 2021, the AIM Small Joint Surgery Guideline has been updated with the following:

 

  • Clarified requirements for imaging reports.
  • Removed radiographic requirement for confirmation of lesser toe deformities.
  • Ankle arthrodesis and total ankle arthroplasty added as new indications for revision of failed previous reconstructions.
  • Removed total ankle arthroplasty requirements for adjacent joint or inflammatory arthritis.
  • Clarified contraindications only apply to total ankle arthroplasty.

 

 

Providers should continue to submit prior authorization review requests to AIM using one of the following ways:

 

  • Access AIM’s ProviderPortallSM 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 at 877-291-0366, Monday–Friday, 7:00 a.m.–5:00 p.m. PT.

 

For questions, please contact the provider number on the back of the member ID card.

 

 

993-0321-PN-CONV

PUBLICATIONS: March 2021 Anthem Provider News and Important Updates -- Nevada