Home Administrative Billing & Reimbursement BlueCard® Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

Clinical Appropriateness Guidelines for Radiology to be updated

May 1, 2019

Effective July 1, 2019, AIM Specialty Health® (AIM), an independent company, will be using updated Clinical Appropriateness Guidelines for Radiology for Independence members.

Independence 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 AIM’s current and future guidelines, go to the Resources section of AIM’s website.

Summary of the changes

Effective July 1, 2019, the following changes will be implemented to the Clinical Appropriateness Guidelines for Radiology:

  • Head and neck imaging
    • Sinusitis/rhinosinusitis
    • Infectious disease – not otherwise specified
    • Inflammatory conditions – not otherwise specified
    • Trauma
    • Neck mass (including lymphadenopathy)
    • Parathyroid adenoma
    • Temporomandibular joint dysfunction
    • Cerebrospinal fluid (CSF) leak of the skull base
    • Dizziness or vertigo
    • Hearing loss

Policies and guidelines

The following policies were posted as Notifications on April 1, 2019, and will go into effect on July 1, 2019. These policies include a list of procedure codes and a link to current and future radiology guidelines on AIM’s website:

  • Commercial: #09.00.46w: High-Technology Radiology Services
  • Medicare Advantage: #MA09.002i: High-Technology Radiology Services

To view the Notifications for these policies, go to our Medical Policy Portal. Select Accept and Go to Medical Policy Online, then select Commercial or Medicare Advantage under Active Notifications.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
Connect with us     Facebook     Twitter     Flickr     YouTube     Walk the Talk    Independence Pinterest    Independence LinkedIn    Independence Instagram Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer
© 2023 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.