February 2020

Starting May 1, additional radiology procedures for our commercial, Medicare Plus Blue members will require prior authorization

Beginning May 1, 2020, the PPO Radiology Management Program, administered by AIM Specialty Health^®, will require prior authorization for additional radiology procedures. This change will apply to Blue Cross Blue Shield of Michigan commercial members, Blue Care Network commercial members and Medicare Plus Blue^SM members.

Here are the procedure codes that will require prior authorization for both office settings and hospital outpatient locations:

Myocardial perfusion imaging, or MPI, and positron emission tomography, or PET, scan:

*78429
*78430
*78431
*78432
*78433

A list of these codes will be available at aimspecialtyhealth.com** in April 2020. You can also refer to Blue Cross’ online provider manuals.

Providers can get authorization through Provider Secured Services at bcbsm.com/providers or by contacting AIM at 1-800-728-8008.

Reminder: Keep in mind that not all of our members require prior authorization through AIM. Benefit Explainer will let you know if a service requires authorization when you enter the patient’s contract number and the procedure code for a service.

**Blue Cross Blue Shield of Michigan doesn’t own or control this website.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2019 American Medical Association. All rights reserved.