AIM General Clinical Guideline
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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 For commercial/Medicare/Medicaid
- Abdominal and pelvic imaging For Simply Healthcare/Florida Medicaid
- Brain imaging For commercial/Medicare/Medicaid
- Brain imaging For Simply Healthcare/Florida Medicaid
- Chest imaging For commercial/Medicare/Medicaid
- Chest imaging For Simply Healthcare/Florida Medicaid
- Extremity imaging
- Head and neck imaging For commercial/Medicare/Medicaid
- Head and neck imaging For Simply Healthcare/Florida Medicaid
- Oncologic imaging For commercial/Medicare/Medicaid
- Oncologic imaging For Simply Healthcare/Florida Medicaid
- Spine imaging
- Vascular imaging For commercial/Medicare/non-Anthem Medicaid
- Vascular imaging For Anthem Medicaid
For commercial, Medicare, and Medicaid members except Indiana Medicaid
COMING SOON EXTREMITY IMAGING GUIDELINES EFFECTIVE SEPTEMBER 11, 2022
COMING SOON SPINE IMAGING GUIDELINES EFFECTIVE SEPTEMBER 11, 2022
COMING SOON VASCULAR IMAGING GUIDELINES EFFECTIVE SEPTEMBER 11, 2022
For commercial, Medicare, and non-Anthem Medicaid members
COMING SOON CHEST IMAGING GUIDELINES EFFECTIVE NOVEMBER 6, 2022
COMING SOON ONCOLOGIC IMAGING GUIDELINES EFFECTIVE NOVEMBER 6, 2022
AIM Clinical Appropriateness Guidelines for Nuclear Imaging
Modalities addressed in the AIM Clinical Appropriateness Guidelines for Nuclear Imaging include scintigraphy and SPECT.
COMING SOON NUCLEAR MEDICINE IMAGING GUIDELINES EFFECTIVE SEPTEMBER 11, 2022
COMING SOON SPECT IMAGING GUIDELINES EFFECTIVE SEPTEMBER 11, 2022
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Accessing Clinical Guidelines and Cancer Treatment Pathways
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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.
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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.
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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.