Anthem Medical Policies for Radiology
| Document # | Medical Policy Title |
| RAD.00001 | Computed Tomography to Detect Coronary Artery Calcification |
| RAD.00036 | MRI of the Breast |
| RAD.00037 | Whole Body Computed Tomography Scanning |
| 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 ABDOMINAL AND PELVIC IMAGING EFFECTIVE FEBRUARY 9, 2020
Brain Imaging
OPEN THE GUIDELINES FOR BRAIN IMAGING EFFECTIVE SEPTEMBER 28, 2019
Chest Imaging
For Commercial and Medicare members
OPEN THE GUIDELINES FOR CHEST IMAGING EFFECTIVE AUGUST 16, 2020 for Commercial and Medicare
For Medicaid members
OPEN THE GUIDELINES FOR CHEST IMAGING EFFECTIVE MARCH 12, 2020 FOR MEDICAID
Extremity Imaging
OPEN THE GUIDELINES FOR EXTREMITY IMAGING EFFECTIVE SEPTEMBER 28, 2019
Head and Neck Imaging
OPEN THE GUIDELINES FOR HEAD AND NECK IMAGING EFFECTIVE JUNE 29, 2019
Oncologic Imaging
For Commercial and Medicare members
OPEN THE GUIDELINES FOR ONCOLOGIC IMAGING EFFECTIVE AUGUST 16, 2020 for Commercial and Medicare
For Medicaid members
OPEN THE GUIDELINES FOR ONCOLOGIC IMAGING EFFECTIVE NOVEMBER 10, 2019 FOR MEDICAID
Spine Imaging
OPEN THE GUIDELINES FOR SPINE IMAGING EFFECTIVE SEPTEMBER 28, 2019
Vascular Imaging
For Commercial and Medicare members
For Medicaid members
OPEN THE GUIDELINES FOR VASCULAR IMAGING EFFECTIVE NOVEMBER 10, 2019 FOR MEDICAID
Please note the Medicaid and Medicare dates are reflective of programs that AIM manages. Medicare and Medicaid markets that aren’t managed by AIM may still utilize this criteria and the effective dates for the criteria will be noted in the market’s provider notice.
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 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 March 9, 2019 – February 8, 2020
- Abdominal and Pelvic Imaging effective January 1, 2019 – March 8, 2019
Brain Imaging
- Brain Imaging effective March 9, 2019 – September 27, 2019
- Brain Imaging effective January 1, 2019 – March 8, 2019
Chest Imaging
- Chest Imaging effective March 12, 2020 – August 15, 2020
- Chest Imaging effective March 9, 2019 – March 11, 2020
- Chest Imaging effective January 1, 2019 – March 8, 2019
Extremity Imaging
- Extremity Imaging effective March 9, 2019 – September 27, 2019
- Extremity Imaging effective January 1, 2019 – March 8, 2019
Head and Neck Imaging
- Head and Neck Imaging effective March 9, 2019 – June 28, 2019
- Head and Neck Imaging effective January 1, 2019 – March 8, 2019
Oncologic Imaging
- Oncologic Imaging effective November 10, 2019 – August 15, 2020
- Oncologic Imaging effective July 14, 2019 – November 9, 2019
- Oncologic Imaging effective March 9, 2019 – July 13, 2019
- Oncologic Imaging effective January 1, 2019 – March 8, 2019
Spine Imaging
- Spine Imaging effective March 9, 2019 – September 27, 2019
- Spine Imaging effective January 1, 2019 – March 8, 2019
Vascular Imaging
- Vascular Imaging effective November 10, 2019 – May 16, 2020
- Vascular Imaging effective March 9, 2019 – November 9, 2019
- Vascular Imaging effective January 1, 2019 – 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