May 2020

Reminder: Additional radiology procedures for commercial and Medicare Plus Blue members to require prior authorization

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

The procedures, which include myocardial imaging and positron emission tomography, involve the following procedure codes:

*78429
*78430
*78431
*78432
*78433

These codes will require preauthorization for both office settings and hospital outpatient locations. A list of the codes is available at aimspecialtyhealth.com.** You can also refer to Blue Cross’ online provider manuals.

Providers can get authorization through the provider portal or by contacting AIM at 1-800-728-8008.

Reminder: Keep in mind that not all 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 and Blue Care Network don’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.