Medicare Advantage
Outreach and Education Bulletin
Empire BlueCross
Enhancements to AIM Clinical Appropriateness Guidelines
for Advanced Imaging effective November 1, 2016
On November 1, 2016, the following changes to the AIM Clinical Appropriateness Guidelines for
Radiology and Cardiology will become effective:
Radiology guidelines
• New guidelines to address pretest requirements for advanced imaging and ordering of
multiple exams
• Head and Neck imaging
o Enhanced criteria for evaluation of cerebral aneurysm and imaging following
head trauma
o Restructure of hearing loss and acoustic neuroma guidelines with addition of
threshold values
• Chest, abdomen and pelvis
o Broadened exclusions for staging or surveillance of certain tumor types across all
CT and MRI modalities
o Updated appropriateness criteria for nephrolithiasis
• Spine imaging
o Enhanced criteria for conservative management prior to imaging for neck pain
and radiculopathy
Cardiology guidelines-Echocardiography
o Enhanced criteria to limit surveillance of asymptomatic patients with reduced LV
function
o Allow for annual surveillance in asymptomatic complex congenital heart disease
o Clarify appropriate use of resting echo in evaluation of chest pain
If you have any questions or comments regarding these enhancements to the guidelines, please
contact AIM via email at aim.guidelines@aimspecialtyhealth.com. Click here to access and
download a copy of the current guidelines.
1633733 06/17/2016
Services provided by Empire HealthChoice Assurance, Inc. licensee of the Blue Cross and Blue Shield Association,
an association of independent Blue Cross and Blue Shield plans.
Medicare Advantage
Outreach and Education Bulletin
Empire BlueCross BlueShield
Enhancements to AIM Clinical Appropriateness Guidelines
for Advanced Imaging effective November 1, 2016
On November 1, 2016, the following changes to the AIM Clinical Appropriateness Guidelines for
Radiology and Cardiology will become effective:
Radiology guidelines
• New guidelines to address pretest requirements for advanced imaging and ordering of
multiple exams
• Head and Neck imaging
o Enhanced criteria for evaluation of cerebral aneurysm and imaging following
head trauma
o Restructure of hearing loss and acoustic neuroma guidelines with addition of
threshold values
• Chest, abdomen and pelvis
o Broadened exclusions for staging or surveillance of certain tumor types across all
CT and MRI modalities
o Updated appropriateness criteria for nephrolithiasis
• Spine imaging
o Enhanced criteria for conservative management prior to imaging for neck pain
and radiculopathy
Cardiology guidelines-Echocardiography
o Enhanced criteria to limit surveillance of asymptomatic patients with reduced LV
function
o Allow for annual surveillance in asymptomatic complex congenital heart disease
o Clarify appropriate use of resting echo in evaluation of chest pain
If you have any questions or comments regarding these enhancements to the guidelines, please
contact AIM via email at aim.guidelines@aimspecialtyhealth.com. Click here to access and
download a copy of the current guidelines.
1633733 06/17/2016
Services provided by Empire HealthChoice Assurance, Inc. licensee of the Blue Cross and Blue Shield Association,
an association of independent Blue Cross and Blue Shield plans.