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
OPEN THE GUIDELINES FOR ABDOMEN AND PELVIS IMAGING EFFECTIVE MARCH 13, 2022
COMING SOON ABDOMEN AND PELVIS IMAGING GUIDELINES EFFECTIVE APRIL 9, 2023
Brain Imaging
OPEN THE GUIDELINES FOR BRAIN IMAGING EFFECTIVE SEPTEMBER 1, 2022
COMING SOON BRAIN IMAGING GUIDELINES EFFECTIVE APRIL 9, 2023
Chest Imaging
For commercial and Medicare members
OPEN THE GUIDELINES FOR CHEST IMAGING GUIDELINES EFFECTIVE NOVEMBER 6, 2022
For Medicaid members
OPEN THE GUIDELINES FOR CHEST IMAGING EFFECTIVE MARCH 13, 2022
For commercial, Medicare, and Medicaid members
COMING SOON CHEST IMAGING GUIDELINES EFFECTIVE APRIL 9, 2023
Extremity Imaging
For commercial, Medicare, and Medicaid members except Indiana Medicaid
OPEN THE GUIDELINES FOR EXTREMITY IMAGING EFFECTIVE SEPTEMBER 11, 2022
For Indiana Medicaid members
OPEN THE GUIDELINES FOR EXTREMITY IMAGING EFFECTIVE SEPTEMBER 12, 2021
Head and Neck Imaging
OPEN THE GUIDELINES FOR HEAD AND NECK IMAGING EFFECTIVE MARCH 13, 2022
COMING SOON HEAD AND NECK IMAGING GUIDELINES EFFECTIVE APRIL 9, 2023
Oncologic Imaging
For commercial and Medicare members
OPEN THE GUIDELINES FOR ONCOLOGIC IMAGING EFFECTIVE NOVEMBER 6, 2022
For Medicaid members
OPEN THE GUIDELINES FOR ONCOLOGIC IMAGING EFFECTIVE SEPTEMBER 1, 2022
For commercial, Medicare, and Medicaid members
COMING SOON ONCOLOGIC IMAGING GUIDELINES EFFECTIVE APRIL 9, 2023
Spine Imaging
For commercial, Medicare, and Medicaid members except Indiana Medicaid
OPEN THE GUIDELINES FOR SPINE IMAGING EFFECTIVE SEPTEMBER 11, 2022
For Indiana Medicaid members
OPEN THE GUIDELINES FOR SPINE IMAGING EFFECTIVE SEPTEMBER 12, 2021
Vascular Imaging
For commercial, Medicare, and Medicaid members except Indiana Medicaid
OPEN THE GUIDELINES FOR VASCULAR IMAGING EFFECTIVE SEPTEMBER 11, 2022
For Indiana Medicaid members
OPEN THE GUIDELINES FOR VASCULAR IMAGING EFFECTIVE SEPTEMBER 12, 2021
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 medical policies, please go to Anthem Provider site > select your state > Scroll down page, select Review Policies > view Medical Policies & Clinical UM GuidelinesOther client policy sites:
- Amerigroup Provider site > Select your state
- Healthlink Provider site
- Healthy Blue LA Provider site
- Healthy Blue SC Provider site
- Simply Healthcare site
- Summit Community Care AR Provider site
- Unicare Provider site
Other Clinical Guidelines
Archived Guidelines
For guidelines older than 3 years, please contact AIM.guidelines@aimspecialtyhealth.com
Abdominal and Pelvic Imaging
- Abdominal and Pelvic Imaging effective November 7, 2021 – March 12, 2022 for commercial and Medicare
- Abdominal and Pelvic Imaging effective March 14, 2021 – March 12, 2022 for Medicaid except Simply Healthcare (FL Medicaid), – September 10, 2022 for Simply Healthcare (FL Medicaid)
- Abdominal and Pelvic Imaging effective March 14 – November 6, 2021 for commercial and Medicare
- Abdominal and Pelvic Imaging effective February 9, 2020 – March 13, 2021
- Abdominal and Pelvic Imaging effective March 9, 2019 – February 8, 2020
- Abdominal and Pelvic Imaging effective January 1 – March 8, 2019
Brain Imaging
- Brain Imaging effective March 13 -August 31, 2022 for commercial, Medicare, and Medicaid except Simply Healthcare (FL Medicaid)
- Brain Imaging effective March 14, 2021 – March 12, 2022 for commercial, Medicare, and Medicaid except Simply Healthcare (FL Medicaid), – September 10, 2022 for 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 March 13, 2022 – November 5, 2022 for commercial and Medicare
- 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), – September 10, 2022 for 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
- Extremity Imaging effective September 12, 2021 – September 10, 2022 for commercial, Medicare, and Medicaid except Indiana Medicaid
- Extremity Imaging effective March 14 – September 11, 2021
- Extremity Imaging effective September 28, 2019 – March 13, 2021
- Extremity Imaging effective March 9 – September 27, 2019
- Extremity Imaging effective January 1 – March 8, 2019
Head and Neck Imaging
- Head and Neck Imaging effective November 7, 2021 – March 12, 2022 for commercial and Medicare
- Head and Neck Imaging effective March 14, 2021 – March 12, 2022 for Medicaid except Simply Healthcare (FL Medicaid), – September 10, 2022 for Simply Healthcare (FL Medicaid)
- Head and Neck Imaging effective March 14 – November 6, 2021 for commercial and Medicare
- Head and Neck Imaging effective June 29, 2019 – March 13, 2021
- Head and Neck Imaging effective March 9 – June 28, 2019
- Head and Neck Imaging effective January 1 – March 8, 2019
Oncologic Imaging
- Oncologic Imaging effective September 1, 2022 – November 5, 2022 for commercial and Medicare
- Oncologic Imaging effective March 13 -August 31, 2022 for commercial, Medicare, and Medicaid except Simply Healthcare (FL Medicaid)
- Oncologic Imaging effective November 7, 2021 – March 12, 2022 for commercial and Medicare
- Oncologic Imaging effective May 1, 2021 – March 12, 2022 for Medicaid except Simply Healthcare (FL Medicaid), – September 10, 2022 for Simply Healthcare (FL Medicaid)
- Oncologic Imaging effective May 1- November 6, 2021 for commercial and Medicare
- Oncologic Imaging effective March 14, 2021 – April 30, 2021
- Oncologic Imaging effective January 1 – March 13, 2021
- Oncologic Imaging effective August 16 – December 31, 2020 for commercial and Medicare, December 19 – 31, 2020 for Medicaid
- Oncologic Imaging effective November 10, 2019 – August 15, 2020 for commercial and Medicare, – December 18, 2020 for Medicaid
- Oncologic Imaging effective July 14 – November 9, 2019
- Oncologic Imaging effective March 9 – July 13, 2019
- Oncologic Imaging effective January 1 – March 8, 2019
Spine Imaging
- Spine Imaging effective September 12, 2021 – September 10, 2022 for commercial, Medicare, and Medicaid except Indiana Medicaid
- Spine Imaging effective March 14 – September 11, 2021
- Spine Imaging effective September 28, 2019 – March 13, 2021
- Spine Imaging effective March 9 – September 27, 2019
- Spine Imaging effective January 1 – March 8, 2019
Vascular Imaging
- Vascular Imaging effective June 12, 2022 – September 10, 2022 for commercial and Medicare
- Vascular Imaging effective September 12, 2021- June 11, 2022 for commercial and Medicare, – September 10, 2022 for Medicaid except Indiana Medicaid
- 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
- Imaging Guidelines – Adult effective October 29, 2018 – December 31, 2018
- Imaging Guidelines – Adult effective March 12, 2018 – October 28, 2018
- Imaging Guidelines – Adult effective January 1, 2018 – March 11, 2018
- Imaging Guidelines – Adult effective November 20, 2017 – December 31, 2017
- Imaging Guidelines – Adult effective September 5, 2017 – November 19, 2017
- Imaging Guidelines – Adult effective February 20, 2017 – September 4, 2017
Complete Set of Imaging Guidelines – Pediatric
- Imaging Guidelines – Pediatric effective October 29, 2018 – December 31, 2018
- Imaging Guidelines – Pediatric effective November 20, 2017 – October 28, 2018
- Imaging Guidelines – Pediatric effective September 5, 2017 – November 19, 2017
- Imaging Guidelines – Pediatric effective February 20, 2017 – September 4, 2017