Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline
This communication applies to the Medicaid and Medicare Advantage programs for Anthem Blue Cross and Blue Shield (Anthem).
Effective for dates of service on and after August 16, 2020, the following updates will apply to the AIM Specialty Health®* (AIM) Sleep Disorder Management Clinical Appropriateness Guideline.
Sleep Disorder Management Clinical Appropriateness Guideline updates by section:
- Bi-Level Positive Airway Pressure (BPAP) Devices:
- Change in BPAP FiO2 from 45 to 52 mmHg based on strong evidence and alignment with Medicare requirements for use of BPAP
- Multiple Sleep Latency Testing and/or Maintenance of Wakefulness Testing:
- Style change for clarity
- Code changes: none
As a reminder, ordering and servicing providers may submit prior authorization (PA) requests to AIM by:
- Accessing AIM’s ProviderPortalSM directly at com. Online access is available 24/7 to process orders in real time, and is the fastest and most convenient way to request PA.
- Accessing AIM via the Availity Portal.*
- Calling the AIM Contact Center at 1-800-714-0040 from 6 a.m. to 6 p.m. CT.
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June 2020 Anthem Provider News - Wisconsin