AIM Specialty Health® (AIM) has updated their Advanced Imaging Clinical Appropriateness Guidelines for Radiology. These new updates affect most Independence Commercial and Medicare Advantage HMO and PPO members and are effective for dates of service on or after March 13, 2022.
In addition, the following changes were made effective March 13, 2022:
- For commercial members, the coverage position of CPT® code 0042T is considered medically necessary and requires precertification with AIM.
- For Medicare Advantage members, the coverage position of CPT code 0042T was changed from experimental/investigational to medically necessary and requires precertification with AIM.
For more information, please read Commercial Medical Policy #09.00.46aj: High-Technology Radiology Services and Medicare Advantage Medical Policy #MA09.002u: High-Technology Radiology Services.
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