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Clinical Appropriateness Guidelines for Radiology to be updated

December 17, 2019

Effective February 9, 2020, AIM Specialty Health® (AIM) will be using updated Clinical Appropriateness Guidelines for Radiology for AmeriHealth members.

AmeriHealth has contracted with AIM to perform utilization management activities for outpatient non-emergent diagnostic imaging services and certain high-technology radiology services for our managed care members. AIM will use the updated Clinical Appropriateness Guidelines for Radiology to determine the medical necessity for these services. To view current and future guidelines, go to the Resources section of AIM’s website.

Summary of the changes

Effective February 9, 2020, changes will be implemented to the Abdomen and Pelvis section of the Clinical Appropriateness Guidelines for Radiology.

Policies and guidelines

The following policies were posted as Notifications on November 11, 2019, and will go into effect on February 9, 2020. These policies include a list of procedure codes and a link to current and future radiology guidelines on AIM’s website:

  • AmeriHealth New Jersey: #09.00.46y: High-Technology Radiology Services (New Jersey)
  • AmeriHealth Pennsylvania: #09.00.46y: High-Technology Radiology Services (Pennsylvania)

To view Notifications for these policies, go to our Medical Policy Portal.


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