Updates to AIM sleep disorder management clinical appropriateness guidelines*
*Material Adverse Change (MAC)
Effective for dates of service on and after September 11, 2022, the following updates will apply to the AIM Specialty Health sleep disorder management clinical appropriateness guidelines. As part of the AIM guideline annual review process, these updates are focused on advancing efforts to drive clinically appropriate, safe, and affordable health care services.
- Established sleep disorder (OSA or other) – follow-up laboratory studies – added indication for one follow-up in-lab sleep study as appropriate following insertion of a hypoglossal nerve stimulator
- Multiple Sleep Latency Testing (MSLT) and/or Maintenance of Wakefulness Testing (MWT) – new indication for MWT in occupational safety evaluation
- Management of OSA using Oral Appliances (OA) – limit guideline for oral appliance use to patients 16 years and older
As a reminder, ordering and servicing providers may submit prior authorization requests to AIM in one of several ways:
- Access AIM’s 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 availity.com
- Call the AIM Contact Center toll-free number: 833-342-1253, Monday through Friday, from 8:30 a.m. to 7:00 p.m. Eastern time
For questions related to guidelines, please contact AIM via email at firstname.lastname@example.org. Additionally, you may access and download a copy of the current and upcoming guidelines here.
June 2022 Anthem Provider News - Wisconsin