AIM CLINICAL APPROPRIATENESS GUIDELINES FOR SPINE SURGERY

The interventions addressed in the AIM Clinical Appropriateness Guidelines for Spine Surgery include bone grafts, bone growth stimulators, foraminotomies, fusions, laminectomy, discectomy, disc arthroplasty, treatment of spinal deformity, and vertebroplasty and kyphoplasty.

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AIM CLINICAL APPROPRIATENESS GUIDELINES FOR JOINT SURGERY

The interventions addressed in the AIM Clinical Appropriateness Guidelines for Joint Surgery include total replacement of the hip, knee, and shoulder; arthroscopy of the hip, knee, and shoulder; treatment of osteochondral defects; and meniscal allograft transplantation.

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AIM CLINICAL APPROPRIATENESS GUIDELINES FOR INTERVENTIONAL PAIN MANAGEMENT

The interventions addressed in the AIM Clinical Appropriateness Guidelines for Interventional Pain Management include epidural steroid injections; paravertebral facet injection, nerve block, and neurolysis; sacroiliac steroid injections; spinal cord stimulators; and regional sympathetic nerve block.

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AIM LEVEL OF CARE GUIDELINES FOR MUSCULOSKELETAL SURGERY AND PROCEDURES

The intent of this guideline is to assist in determining the appropriate level of care needed to safely and effectively perform the planned spine or joint surgical procedure. In addition to the guideline requirements, AIM will also consider the geographical proximity, availability, and capability of in-network facilities and the requesting provider's existing surgical privileges status.

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AIM PREOPERATIVE ADMISSION GUIDELINES FOR MUSCULOSKELETAL SURGERY AND PROCEDURES

The intent of this guideline is to assist in determining the appropriate indications for hospital admission prior to elective musculoskeletal surgical procedures. The guideline does not apply to fractures, infections, tumors, or other emergent non-elective cases.

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The Level of Care and Preoperative Admission guidelines do not address the clinical appropriateness of a procedure. The AIM prior authorization process for clinical appropriateness of the surgical procedure is completed separately and precedes the level of care determination.

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