This article was revised on July 31, 2020, to update the effective timeline.
AmeriHealth is committed to providing our members with access to the care they need during the COVID-19 pandemic. We encourage all AmeriHealth members and providers to visit our dedicated AmeriHealth New Jersey and AmeriHealth Pennsylvania COVID-19 webpages regularly for the latest news and updates. We will continue to evaluate member needs as the situation changes.
Changes to AIM guidelines
Effective March 6, 2020, through September 4, 2020, AIM Specialty Health® (AIM) has revised their Clinical Appropriateness Guidelines for Advanced Imaging – Appropriate Use Criteria: Imaging of the Chest. The change is subject to re-revaluation for the duration of the public health emergency. The revised guidelines are available on AIM's website.
The summary changes to the Guideline are as follows:
- Chest imaging:
- Allow CT for diagnosis of COVID-19 pneumonia
Advanced imaging of the chest is considered medically necessary for individuals under investigation, as defined by the Centers for Disease Control and Prevention (CDC), for Coronavirus Disease 2019 (COVID-19) pneumonia when reverse transcription polymerase chain reaction (RT-PCR) is negative or cannot be performed.
You can view the complete announcement, Computed tomography (CT) chest imaging for diagnosis of COVID-19 pneumonia, in the News & Announcements section of our Medical Policy Portal.
For more information about the AmeriHealth position on COVID-19, please review the following resources: