Reminder: Prior authorization changes to AIM authorization program for MA PPO members begin May 1, 2019

Starting May 1, 2019, certain cardiac procedures and in-lab sleep testing will require prior authorization through AIM Specialty Health for Medicare Plus Blue^SM PPO members. This includes UAW Retiree Medical Benefits Trust members with Medicare Plus Blue coverage.

The PPO radiology management program added the cardiology and in-lab sleep study prior authorization program earlier this year.

The additional cardiac procedures below require prior authorization for Medicare Plus Blue members:

Percutaneous coronary intervention

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

Diagnostic coronary catheterization

• *93454 through *93461

Note: URMBT commercial PPO members are excluded from the prior authorization requirement for the expanded cardiology services described above.

Blue Cross Blue Shield of Michigan now requires prior authorization for in-lab sleep testing by in-state providers for Medicare Plus Blue for the following procedure codes:

• *95805
• *95807
• *95808
• *95810
• *95811

In addition, the high-tech radiology program (breast MRI) now requires Blue Cross commercial PPO and Medicare Plus Blue PPO members to get prior authorization through AIM for the procedure codes below:

• *77046 through *77049

How to request authorization

• Go to AIM’s provider portal at aimspecialtyhealth.com.
• Call AIM at 1-800-728-8008.

For more information

Refer to the February 2019 Record article or the FAQ for more information.