Aug 17, 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-certification requests to AIM in one of the following ways:

 

  • Access AIM 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.

 

  • Access AIM via the Availity Web Portal at com.

 

  • Call the AIM Contact Center toll-free number: 866-789-0397, Monday – Friday, 8 a.m. to 5 p.m. ET.

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.


Featured In:
August 2018 Anthem Provider Newsletter -- Virginia