Reminder: Preauthorization for abdomen and pelvis CT scans

As part of Blue Cross Blue Shield of Michigan’s radiology management program, physicians must obtain preauthorization through AIM Specialty Health^® for any nonemergency outpatient CT scans. The procedure performed must match the preauthorized procedure in order for the imaging claim to be paid.

Blue Cross recently received questions about CT abdomen (*74150, *74160, *74170), CT pelvis (*72192-*72194), and CT abdomen pelvis combination tests (*74176-*74178). It’s important to note that the preauthorization process for these exams includes some specific rules:

• When the imaging service is performed and it’s determined that a procedure other than the one preauthorized is more appropriate, the imaging facility must contact the ordering physician to change the order. The ordering physicians’ staff should then withdraw the original request and obtain authorization for the new procedure.
• In these specific circumstances, we provide a 48-hour, post-procedure window for the ordering physician to obtain the new authorization.

Before rendering any imaging services, providers should validate the authorized exams from the ordering physician by calling AIM at 1-800-728-8008 or accessing this information online through AIM’s provider portal at aimspecialtyhealth.com.**

These rules apply to Medicare Advantage and commercial members in Michigan. If you have any questions, contact your provider consultant.

**BCBSM does not control this website or endorse its general content.