Currently, durable medical equipment (DME) providers request precertification of spinal bone growth stimulators through AmeriHealth.
Effective January 1, 2018, AmeriHealth will delegate precertification of spinal bone growth stimulators, HCPCS code E0748, to AIM Specialty Health® (AIM) for all commercial members as part of the new Musculoskeletal Utilization Management Program.
Please note that precertification of non-spinal bone growth stimulators, HCPCS code E0747, will continue to be performed by AmeriHealth.
Submitting requests through AIM
All precertification requests for spinal bone growth stimulators should be submitted using AIM's ProviderPortalSM. Providers can access AIM's ProviderPortal directly through AIM's website or through the NaviNet® web portal by selecting Authorizations from the Workflows menu, then AIM.
It is very important for providers to use NaviNet to verify member eligibility and benefits and refer to the most current precertification requirement lists for AmeriHealth New Jersey and AmeriHealth Pennsylvania. Failure to obtain required precertification for services may result in a reduction in payment or nonpayment for the services provided but not precertified.
Learn more
For additional information on bone growth stimulators, refer to Medical Policy #05.00.09i: Electrical Bone Growth Stimulation and Low-Intensity Ultrasound Accelerated Fracture, which is currently posted as a Notification and will go into effect January 1, 2018.
To view the Notification for this policy, visit our Medical Policy Portal and select Accept and Go to Medical Policy Online. Then select Commercial under Active Notifications.
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