New indication for Popliteal artery aneurysm US surveillance post-repair (2021 SVS guidelines)Īs a reminder, ordering and servicing providers may submit prior authorization requests to AIM in one of several ways:.Suspected PAD without physiologic testing (including exercise testing) not indicated.Upper or lower extremity peripheral arterial disease (PAD):.Aneurysm of the abdominal aorta or iliac arteries – Management/surveillance scenarios aligned with SVS guidelines.Stenosis or occlusion, extracranial carotid arteries – Post-revascularization scenario aligned with the Society for Vascular Surgery (SVS) guidelines to allow annual surveillance regardless of residual stenosis.Imaging study modality and/or site expansion – Pulsatile tinnitus, acute aortic syndrome, abdominal venous thrombosis.Pulmonary embolism – Removal of nondiagnostic chest radiograph (CXR) requirement (lower threshold for elevated D-dimer scenarios, thrombosis related to COVID-19 infection, etc.).
Chronic stroke/TIA – New indication modality approach by circulation presentation.Stroke/Transient ischemic attack (TIA), extracranial evaluation – Subacute stroke/TIA computed tomography angiography (CTA)/magnetic resonance angiography (MRA) neck allowed without prerequisite ultrasound (US), in alignment with 2021 American Heart Association (AHA)/American Stroke Association (ASA) guidelines.Stenosis or occlusion, extracranial carotid arteries – New indications for post neck irradiation, incidental carotid calcification scenarios.Perioperative imaging – Excluded robotic-assisted hip arthroplasty as robotic-assisted surgery in general does not provide net benefit over conventional arthroplasty.Shoulder arthroplasty – Modified language to clarify intent regarding limited scenarios where advanced imaging is indicated for total shoulder arthroplasty.Rotator cuff tear – Combined acute and chronic rotator cuff tear criteria standardized conservative management duration to 6 weeks.Trauma – Added computerized tomography (CT) scan as an alternative to magnetic resonance imaging (MRI) for tibial plateau fracture added indication for evaluation of supracondylar fracture.Perioperative and periprocedural imaging – Added requirement for initial evaluation with radiographs.As part of the AIM guideline annual review process, these updates are focused on advancing efforts to drive clinically appropriate, safe, and affordable healthcare services. Effective for dates of service on and after September 11, 2022, the following updates will apply to theĪIM Specialty Health ®* (AIM) Advanced Imaging Clinical Appropriateness Guidelines.
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