AIM General Clinical Guideline
OPEN THE GENERAL CLINICAL GUIDELINE
AIM Clinical Appropriateness Guidelines for Radiology
The foundation of our solution platform for specialty benefits management is our clinical appropriateness guidelines.
AIM Clinical Appropriateness Guidelines for Radiology are developed through a rigorous process integrating evidence-based literature with expert physician review. Included are guidelines for advanced imaging and nuclear medicine imaging.
The Guidelines do not address coverage, benefit or other plan specific issues. Applicable federal and state coverage mandates take precedence over these clinical guidelines. If requested by a health plan, AIM will review requests based on health plan medical policy/guidelines in lieu of the AIM Guidelines.
AIM Clinical Appropriateness Guidelines for Advanced Imaging
Modalities addressed in the AIM Clinical Appropriateness Guidelines for Advanced Imaging include CT, MRI, MRA, PET, quantitative CT, and arterial ultrasound.
- Abdominal and pelvic imaging
- Brain imaging
- Chest imaging for commercial, Medicare, and non-Anthem Medicaid
- Chest imaging for Anthem Medicaid
- Extremity imaging
- Extremity imaging for Indiana Medicaid
- Head and neck imaging
- Oncologic imaging for commercial, Medicare, and non-Anthem Medicaid
- Oncologic imaging for Anthem Medicaid
- Spine imaging
- Spine imaging for Indiana Medicaid
- Vascular imaging
- Vascular imaging for Indiana Medicaid
COMING SOON ABDOMEN AND PELVIS IMAGING GUIDELINES EFFECTIVE APRIL 9, 2023
COMING SOON BRAIN IMAGING GUIDELINES EFFECTIVE APRIL 9, 2023
COMING SOON CHEST IMAGING GUIDELINES EFFECTIVE APRIL 9, 2023
COMING SOON HEAD AND NECK IMAGING GUIDELINES EFFECTIVE APRIL 9, 2023
COMING SOON ONCOLOGIC IMAGING GUIDELINES EFFECTIVE APRIL 9, 2023
AIM Clinical Appropriateness Guidelines for Nuclear Imaging
Modalities addressed in the AIM Clinical Appropriateness Guidelines for Nuclear Imaging include scintigraphy and SPECT.
AIM Clinical Appropriateness Guidelines for Advanced Imaging Site of Care
The AIM Clinical Appropriateness Guidelines for Site of Care address the medical necessity of advanced imaging performed at a hospital outpatient department. Modalities include CT, MRI, MRA, PET, and quantitative CT.
COMING SOON SITE OF CARE FOR ADVANCED IMAGING GUIDELINES EFFECTIVE APRIL 1, 2023
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CLINICAL GUIDELINES ACCESS
Accessing Clinical Guidelines and Cancer Treatment Pathways
By clicking on the “I accept” button below, I acknowledge I accept the following terms and conditions when accessing and using the Clinical Guidelines and Cancer Treatment Pathways:
AIM Specialty Health® (AIM) has developed proprietary Clinical Guidelines and Cancer Treatment Pathways (together with any updates, referred to collectively as the “Guidelines and Pathways”). The Guidelines and Pathways are designed to evaluate and direct the appropriate utilization of certain health care services. They are based on data from peer-reviewed scientific literature, from criteria developed by specialty societies, and from guidelines adopted by other health care organizations. Access to these Guidelines and Pathways is being provided for informational purposes only. Although AIM has a process for updating its Guidelines and Pathways on a regular basis, due to the rapidly evolving nature of medicine, these Guidelines and Pathways may not reflect the most current evidence on a particular service or treatment.
The Guidelines and Pathways are protected by copyright of AIM as permitted by and to the full extent of the law. These rights are not released, transferred, or assigned as a result of allowing access. You agree that you do not have any ownership rights to the Guidelines and Pathways and that you are expressly prohibited from selling, assigning, leasing, licensing, reproducing, or distributing the Guidelines and Pathways unless authorized in writing by AIM.
The Guidelines and Pathways do not constitute medical advice and/or medical care and do not guarantee results or outcomes. The Guidelines and Pathways are not a substitute for the experience and judgment of a physician or other health care professionals. Any clinician seeking to apply or consult the Guidelines or Pathways is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient’s care or treatment. The Guidelines and Pathways do not address coverage, benefit, or other plan specific issues.
The Guidelines and Pathways are provided “as is” without warranty of any kind, either expressed or implied. The search feature is available for convenience only. Lack of search results for a code or keyword does not imply it is not applicable to AIM guidelines or that prior authorization is not required. Guidelines are subject to change. They should not be accessed via bookmarks or saved links as doing so may result in inaccurate information. AIM disclaims all responsibility for any consequences or liability attributable or related to any use, nonuse, or interpretation of information contained in the Guidelines.
About the AIM Clinical Appropriateness Guidelines for Genetic Testing
The AIM Clinical Appropriateness Guidelines for Genetic Testing (with any updates, referred to as the “Genetic Testing Guidelines”) were developed by and used with permission from Informed Medical Decisions, Inc.
The Genetic Testing Guidelines are protected by copyright of Informed Medical Decisions, Inc., as permitted by and to the full extent of the law. These rights are not released, transferred, or assigned as a result of allowing access. You agree that you do not have any ownership rights to the Genetic Testing Guidelines and that you are expressly prohibited from selling, assigning, leasing, licensing, reproducing, or distributing the Genetic Testing Guidelines unless authorized in writing by Informed Medical Decisions.
AIM and Informed Medical Decisions, Inc., disclaim all responsibility for any consequences or liability attributable or related to any use, nonuse, or interpretation of information contained in the Genetic Testing Guidelines.