Effective January 10, 2021, AmeriHealth is updating our policies on Musculoskeletal Services to communicate the use of AIM Specialty Health® (AIM) Medical Necessity guidelines for select interventional pain management and spinal and joint surgical procedures with the exception of artificial intervertebral lumbar disc insertion for AmeriHealth New Jersey and AmeriHealth Pennsylvania members. Previously, we followed our medical policies for all of these services.
The current policies on Musculoskeletal Services will remain in place for AmeriHealth Administrators.
For more information please refer to the following AmeriHealth policies, which will be posted as Notifications on October 12, 2020, and will go into effect on January 10, 2021:
- #00.01.66c: Musculoskeletal Services (AmeriHealth New Jersey and AmeriHealth Pennsylvania)
- #11.14.19p: Artificial Intervertebral Cervical Disc Insertion (AmeriHealth Administrators)
- #11.15.31: Artificial Intervertebral Lumbar Disc Insertion (AmeriHealth New Jersey, AmeriHealth Pennsylvania, and AmeriHealth Administrators)
To view the Notifications for these policies, visit our Medical and Claim Payment Policy Portal.