June 2019

Cardiology procedures and in-lab sleep study assessments added to Medicare Plus Blue PPO radiology management program

On May 1, 2019, the radiology management program administered by AIM Specialty Health^® added authorization requirements for select cardiology procedures and for in-lab sleep study assessments for Medicare Plus Blue^SM PPO members.

The program includes UAW Retiree Medical Benefits Trust members with Medicare Plus Blue coverage.

Following are the CPT codes for the procedures that were added to the program.

Percutaneous coronary intervention:

*92920
*92924
*92928
*92933
*92937
*92943

Note: For these procedures, we require review for medical necessity and clinical appropriateness after the service has been completed. Due to the medical nature of this procedure, we don't require pre-service review for the codes listed above.

Diagnostic coronary catheterization:

*93454
*93455
*93456
*93457
*93458
*93459
*93460
*93461

Note: The diagnostic coronary catherization codes listed above require prior authorization.

In-lab sleep studies:

*95805
*95806
*95807
*95808
*95810
*95811

Note: The sleep study codes listed above require prior authorization.

Questions?

If you have questions, call 1-800-728-8008. You can also visit the AIM website.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2018 American Medical Association. All rights reserved.