RADIOLOGY

Anthem Medical Policies for Radiology

Document # Medical Policy Title
RAD.00036 MRI of the Breast
RAD.00052 Positional MRI

AIM General Clinical Guideline

OPEN THE GENERAL CLINICAL GUIDELINE EFFECTIVE AUGUST 17, 2020

AIM Clinical Guidelines for Advanced Imaging

Abdominal and Pelvic Imaging

For commercial, Medicare, and Medicaid members except Simply Healthcare (Florida Medicaid)

OPEN THE GUIDELINES FOR ABDOMEN AND PELVIS IMAGING EFFECTIVE MARCH 13, 2022 FOR COMMERCIAL/MEDICARE/MEDICAID

For Simply Healthcare (Florida Medicaid) members

OPEN THE GUIDELINES FOR ABDOMEN AND PELVIS IMAGING EFFECTIVE MARCH 14, 2021 FOR SIMPLY HEALTHCARE/FL MEDICAID

Brain Imaging

For commercial, Medicare, and Medicaid members except Simply Healthcare (Florida Medicaid)

OPEN THE GUIDELINES FOR BRAIN IMAGING EFFECTIVE MARCH 13, 2022 FOR COMMERCIAL/MEDICARE/MEDICAID

For Simply Healthcare (Florida Medicaid) members

OPEN THE GUIDELINES FOR BRAIN IMAGING EFFECTIVE MARCH 14, 2021 FOR SIMPLY HEALTHCARE/FLORIDA MEDICAID

Chest Imaging

For commercial, Medicare, and Medicaid members except Simply Healthcare (Florida Medicaid)

OPEN THE GUIDELINES FOR CHEST IMAGING EFFECTIVE MARCH 13, 2022 FOR COMMERCIAL/MEDICARE/MEDICAID

For Simply Healthcare (Florida Medicaid) members

OPEN THE GUIDELINES FOR CHEST IMAGING EFFECTIVE MARCH 14, 2021 FOR SIMPLY HEALTHCARE/FLORIDA MEDICAID

For commercial and Medicare members

COMING SOON CHEST IMAGING GUIDELINES EFFECTIVE NOVEMBER 6, 2022

Extremity Imaging

For commercial, Medicare, and Medicaid members

OPEN THE GUIDELINES FOR EXTREMITY IMAGING EFFECTIVE SEPTEMBER 12, 2021

For commercial, Medicare, and Medicaid members except Indiana Medicaid

COMING SOON EXTREMITY IMAGING GUIDELINES EFFECTIVE SEPTEMBER 11, 2022

Head and Neck Imaging

For commercial, Medicare, and Medicaid members except Simply Healthcare (Florida Medicaid)

OPEN THE GUIDELINES FOR HEAD AND NECK IMAGING EFFECTIVE MARCH 13, 2022 FOR COMMERCIAL/MEDICARE/MEDICAID 

For Simply Healthcare (Florida Medicaid) members

OPEN THE GUIDELINES FOR HEAD AND NECK IMAGING EFFECTIVE MARCH 14, 2021 FOR SIMPLY HEALTHCARE/FLORIDA MEDICAID

Oncologic Imaging

For commercial, Medicare, and Medicaid members except Simply Healthcare (Florida Medicaid)

OPEN THE GUIDELINES FOR ONCOLOGIC IMAGING EFFECTIVE MARCH 13, 2022 FOR COMMERCIAL/MEDICARE/MEDICAID

For Simply Healthcare (Florida Medicaid) members

OPEN THE GUIDELINES FOR ONCOLOGIC IMAGING EFFECTIVE MAY 1, 2021 FOR SIMPLY HEALTHCARE/FLORIDA MEDICAID

For commercial and Medicare members

COMING SOON ONCOLOGIC IMAGING GUIDELINES EFFECTIVE NOVEMBER 6, 2022

Spine Imaging

For commercial, Medicare, and Medicaid members

OPEN THE GUIDELINES FOR SPINE IMAGING EFFECTIVE SEPTEMBER 12, 2021

For commercial, Medicare, and Medicaid members except Indiana Medicaid

COMING SOON SPINE IMAGING GUIDELINES EFFECTIVE SEPTEMBER 11, 2022

Vascular Imaging

For commercial and Medicare members

OPEN THE GUIDELINES FOR VASCULAR IMAGING EFFECTIVE JUNE 12, 2022

For Medicaid members

OPEN THE GUIDELINES FOR VASCULAR IMAGING EFFECTIVE SEPTEMBER 12, 2021

For commercial, Medicare, and Medicaid members except Indiana Medicaid

COMING SOON VASCULAR IMAGING GUIDELINES EFFECTIVE SEPTEMBER 11, 2022

Code cross-reference guide

Download a helpful spreadsheet to find current and archived procedure codes for each solution!

Anthem medical policy site:

For a complete listing of Anthem medical policies, please go to Anthem Provider site > select your state > Scroll down page, select Review Policies > view Medical Policies & Clinical UM Guidelines

Other client policy sites:

Other Clinical Guidelines

Archived Guidelines

For guidelines older than 3 years, please contact AIM.guidelines@aimspecialtyhealth.com

Abdominal and Pelvic Imaging
Brain Imaging
  • Brain Imaging effective March 14, 2021 – March 12, 2022 for commercial, Medicare, and Medicaid except Simply Healthcare (FL Medicaid)
  • Brain Imaging effective September 28, 2019 – March 13, 2021
  • Brain Imaging effective March 9 – September 27, 2019
  • Brain Imaging effective January 1 – March 8, 2019
Chest Imaging
  • Chest Imaging effective November 7, 2021 – March 12, 2022 for commercial and Medicare
  • Chest Imaging effective March 14, 2021 – March 12, 2022 for Medicaid except Simply Healthcare (FL Medicaid)
  • Chest Imaging effective March 14 – November 6, 2021 for commercial and Medicare
  • Chest Imaging effective January 1 – March 13, 2021
  • Chest Imaging effective August 16 – December 31, 2020 for commercial and Medicare, December 19 – 31, 2020 for Medicaid
  • Chest Imaging effective March 12 – August 15, 2020 for commercial and Medicare, – December 18, 2020 for Medicaid
  • Chest Imaging effective March 9, 2019 – March 11, 2020
  • Chest Imaging effective January 1 – March 8, 2019
Extremity Imaging
Head and Neck Imaging
Oncologic Imaging
Spine Imaging
Vascular Imaging
  • Vascular Imaging effective September 12, 2021- June 11, 2022 for commercial and Medicare
  • Vascular Imaging effective March 14 – September 11, 2021
  • Vascular Imaging effective January 1 – March 13, 2021
  • Vascular Imaging effective May 17- December 31, 2020 for commercial, August 16 – December 31, 2020 for Medicare, December 19 – 31, 2020 for Medicaid
  • Vascular Imaging effective November 10, 2019 – May 16, 2020 for commercial, – August 15, 2020 for Medicare, – December 18, 2020 for Medicaid
  • Vascular Imaging effective March 9 – November 9, 2019
  • Vascular Imaging effective January 1 – March 8, 2019

2017-2018

Complete Set of Imaging Guidelines – Adult
Complete Set of Imaging Guidelines – Pediatric