Effective November 10, 2019, 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 November 10, 2019, changes will be implemented to the following sections of the
Clinical Appropriateness Guidelines for Radiology:
- Oncologic imaging
- Vascular imaging
- Imaging of the heart
To review the specific changes, please read the News & Announcements article,
Clinical Appropriateness Guidelines for Radiology to be updated for AmeriHealth Members, announcing the updates that were posted to our Medical Policy Portal on
August 8, 2019.
Policies and guidelines
The following policies were posted as Notifications on August 16, 2019, and will go into effect on
November 10, 2019. These policies include a list of procedure codes and a link to current and future radiology guidelines on AIM’s website:
-
AmeriHealth New Jersey: #09.00.46x: High-Technology Radiology Services (New Jersey)
-
AmeriHealth Pennsylvania: #09.00.46x: High-Technology Radiology Services (Pennsylvania)
To view Notifications for these policies, go to our Medical Policy Portal.