Updates to AIM Specialty Health Advanced Imaging clinical appropriateness guidelines
Updates by guideline:
- Imaging of the Brain:
- Acoustic neuroma — removed indication for CT brain and replaced with CT temporal bone
- Meningioma — new guideline establishing follow-up intervals
- Pituitary adenoma — removed allowance for CT following nondiagnostic MRI in macroadenoma
- Tumor, not otherwise specified — added indication for management; excluded surveillance for lipoma and epidermoid without suspicious features
- Imaging of the Head and Neck:
- Parathyroid adenoma — specified scenarios where surgery is recommended based on American Association of Endocrine Surgeons guidelines
- Temporomandibular joint dysfunction — specified duration of required conservative management
- Imaging of the Heart:
- Coronary CT angiography — removed indication for patients undergoing evaluation for transcatheter aortic valve implantation/replacement who are at moderate coronary artery disease risk
- Imaging of the Chest:
- Pneumonia — removed indication for diagnosis of COVID-19 due to availability and accuracy of lab testing
- Pulmonary nodule — aligned with Lung-RADS for follow-up of nodules detected on lung cancer screening CT
- Imaging of the Abdomen and Pelvis:
- Uterine leiomyomata — new requirement for ultrasound prior to MRI; expanded indication beyond uterine artery embolization to include most other fertility-sparing procedures
- Intussusception — removed as a standalone indication
- Jaundice — added requirement for ultrasound prior to advanced imaging in pediatric patients
- Sacroiliitis — defined patient population in whom advanced imaging is indicated (predisposing condition or equivocal radiographs)
- Azotemia — removed as a standalone indication
- Hematuria — modified criteria for advanced imaging of asymptomatic microhematuria based on AUA guideline
- Diffuse liver disease – new indication for multiparametric MRI for fibrosis and hemochromatosis
- Oncologic Imaging:
- National Comprehensive Cancer Network (NCCN) recommendation alignments for breast cancer, Hodgkin and Non-Hodgkin lymphoma, neuroendocrine tumor, melanoma, soft tissue sarcoma, testicular cancer, and thyroid cancers.
- Cancer screening — new age parameters for pancreatic cancer screening; new content for hepatocellular carcinoma screening
- Breast cancer — clinical scenario clarifications for diagnostic breast MRI and PET/CT
As a reminder, ordering and servicing providers may siubmit prior authorization requests to AIM via:
- AIM’s ProviderPortalSM directly at providerportal.com.
- Online access is available 24/7 to process orders in real-time and is the fastest and most convenient way to request authorization.
- The Availity* Portal at availity.com.
- Phone at 855-574-6481, Monday through Friday from 8 a.m. to 8 p.m. ET.
If you have questions related to guidelines, email AIM at email@example.com. Additionally, you may access and download a copy of the current and upcoming guidelines online.
December 2021 Newsletter