New Hampshire
Provider Communications

Aug 1, 2018 • Products & Programs

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 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.

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.