Effective November 1, 2012, AIM Specialty Health
SM (AIM) will
implement updated imaging clinical guidelines as a result of their 2012
guideline review process. The process to request prior authorization is not
affected; however, there are other important updates that will affect the
following diagnostic imaging services:
computed tomography (CT) or magnetic resonance imaging (MRI) of the spine
CT or MRI of the brain
computed tomography angiography (CTA) of the chest
myocardial perfusion imaging (MPI)/stress echocardiography*
For specific details on the changes made to these guidelines, please review the
article posted to our
Med
ical Policy website which outlines each of the changes and provides the
clinical rationale and relevant medical literature.
Also effective November 1, 2012, in support of AIM?s existing guideline on
"Simultaneous Ordering of Multiple Imaging Tests," requests that involve
multiple examinations of contiguous body parts that cannot be approved prior to
AIM physician review will require a peer-to-peer conversation. If the AIM
physician reviewer cannot reach the ordering provider, none of the multiple
exams requested will be approved.
These changes will be reflected in the clinical guidelines, which will be
available on the
AIM website
once they go into effect.
*Stress echocardiography updates are for AmeriHealth New
Jersey members only.