RADIOLOGY

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

OPEN THE GUIDELINES FOR VASCULAR IMAGING EFFECTIVE MAY 17, 2020 for Commercial – AUGUST 16, 2020 for Medicare

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 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
Chest Imaging
Extremity Imaging
Head and Neck Imaging
Oncologic Imaging
Spine Imaging
Vascular Imaging

2017-2018

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