AIM updating clinical guidelines for prostate cancer imaging in March

Starting March 13, 2022, AIM Specialty Health^® will publish updated oncologic imaging clinical guidelines for prostate cancer to include indications for 18FDCFPyL (piflufolastat injection or Pylarify^®) PET/CT imaging (radiology procedure code *78815).

In the future, these scans will be available for you to select when you submit prior authorizations requests to AIM.

Until you’re able to select these scans, use the “free text” field in the prior authorization request and:

• Enter “PET w/ Pylarify, tumor stage and prior treatment (prostatectomy and/or radiation).”  
• List the conventional imaging that has been completed (MRI prostate/pelvis, CT or bone scan) and the results of those procedures.

This applies to the following members:

• Blue Cross Blue Shield of Michigan commercial
• Medicare Plus Blue℠
• Blue Care Network commercial
• BCN Advantage℠

Where to find AIM’s clinical guidelines

You can find AIM’s clinical guidelines for oncologic management on the Current Radiology Guidelines** webpage on the AIM website. Scroll down to Oncologic Imaging. Then scroll down to Prostate Cancer.

Submitting prior authorization requests

Submit prior authorization requests to AIM. For information on how to submit requests and other resources, visit these webpages on our ereferrals.bcbsm.com website:

• Blue Cross AIM-Managed Procedures
• BCN AIM-Managed Procedures

**Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.

AIM is an independent company that contracts with Blue Cross Blue Shield of Michigan to provide benefit management services.