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AIM Prior Authorization List 

Advanced imaging studies (MRI, MRA, CT, PET scans and Nuclear Cardiology) performed in a non-emergent outpatient setting require prior authorization through American Imaging Management (AIM) Specialty Health.

Prior authorization is required for Medicare Advantage as well as most of our Commercial products. Click here to access Blue Cross of Idaho groups who are NOT participating in the prior authorization program for advanced imaging. Groups on this list do not require prior authorization for their members.

A prior authorization approval is a determination of medical necessity only and not a guarantee of reimbursement.  We determine coverage and reimbursement based on the benefits, exclusions and limitations of the specific policy. For information regarding member benefits please access our Web site at www.bcidaho.com or contact our Customer Services Department toll free at 1 866-482-2250.

Last updated 02/01/2012

 

AIM Code Grouping Parent Code      Grouped Codes                                  
(CT) Computed Tomography Scans 74150 74150, 74160, 74170
  74176 74176, 74177, 74178
  71250 71250, 71260, 71270
  73200 73200, 73201, 73202
  73700 73700, 73701, 73702
  70450 70450, 70460, 70470
  70480 70480, 70481, 70482
  70486 70486, 70487, 70488
  70490 70490, 70491, 70492
  72192 72192, 72193, 72194
 f 72125 72125, 72126, 72127
  72128 72128, 72129, 72130
  72131 72131, 72132, 72133
(CTA) Computed Tomography Angiography Scans 74174 74174
   74175 74175
  75635 75635
  71275 71275
  73206 73206
  73706 73706
  70496 70496
  70498 70498
  72191 72191
(MRI) Magnetic Resonance Imaging 74181 74181, 74182, 74183
  77084 77084
  77058 77058, 77059, C8903, C8904, C8905
  71550 71550, 71551, 71552, C8906, C8907, C8908, C8909, C8910, C8911
  75557 75557, 75559, 75561, 75563, 75565
  73218 73218, 73219, 73220
  73221 73221, 73222, 73223
  73721 73718, 73719, 73720, 73721, 73722, 73723, C8912, C8913, C8914
  70336 70336
  70540 70540, 70542, 70543
  70551 70551, 70552, 70553
  72195 72195, 72196, 72197, C8918, C8919, C8920
  72141 72141, 72142, 72156
  72146 72146, 72147, 72157
  72148 78148, 72149, 72158
(MRA) Magnetic Resonance Angiography 74185 74185, C8900, C8901, C8902
  71555 71555
  73225 73225
  73725 73725
  70544 70544, 70545, 70546
  70547 70547, 70548, 70549
  72198 72198
  72159 72159
(MRS) Magnetic Resonance Spectroscopy 76390 76390 
Nuclear Cardiology 78451 78451, 78452, 78453, 78454
  78469 78466, 78468, 78469
  78472 78472, 78473, 78481, 78483, 78494
(PET) Positron Emission Tomography 78608 78608, 78609
  78459 78459, 78491, 78492
PET & CT/PET 78813 78811, 78812, 78813, 78814, 78815, 78816 
Screening CT Colonoscopy 74263 74263 
Diagnostic CT Colonoscopy

74261

74261, 74262 
CT Heart without contrast 75571 75571 
CT Heart with contrast 75572 75572, 75573 
CTA Heart 75574 75574 
(fMRI) Functional MRI 70554 70554, 70555 
Secondary Codes 76376 3D interpretation and report of CT, MRI, ULS or other Tomographic modality; not requiring image post processing on an independent workstation
  76377 3D interpretation and report of CT, MRI, ULS or other Tomographic modality; requiring image post processing on an independent workstation
  78496 Add on code to 78472 ONLY