|
April 2018
New programs and preauthorization changes to PPO radiology management program take effect July 1, 2018
Beginning on July 1, 2018, the PPO radiology management program, administered by AIM Specialty Health, will be adding a cardiology and in-lab sleep study program for Medicare Advantage PPO members and a cardiology program for PPO members.
The additional cardiac procedures for both commercial and Medicare Plus BlueSM members will include:
- Percutaneous coronary intervention
- Peripheral vascular ultrasound
- Diagnostic coronary catheterization
Additionally, Blue Cross Blue Shield of Michigan will require prior authorization for in-lab sleep testing by instate providers for Medicare Plus Blue. Preapproval must be obtained for the following procedure codes:
- *95805
- *95807
- *95808
- *95810
- *95811
The in-lab sleep study program is similar to what we have in place for non-MA commercial PPO.
All authorized attended sleep study services should be performed at a laboratory or center accredited by the American Academy of Sleep Medicine or the Joint Commission.
All TRUST providers performing sleep study services for our PPO members must be certified in sleep medicine by a board recognized by Blue Cross.
The procedure codes will require preauthorization for both office settings and hospital outpatient locations. A list of these codes will be available at aimspecialtyhealth.com** in June 2018. You can also refer to Blue Cross’ online provider manuals.
You can get authorization through AIM’s provider portal at aimspecialtyhealth.com** or by contacting AIM at 1-800-728-8008.
** Blue Cross Blue Shield of Michigan doesn’t own or control this website.
| 
