Our contracted providers are required to participate in all quality improvement initiatives and programs as indicated in their provider agreements.
Ordering/referring non-radiological physicians, other health care professionals and/or their trained staff must contact AIM Specialty Health (AIM) to obtain an order number before scheduling an elective outpatient diagnostic imaging procedure for any member who participates in this program.
Note: Non-radiology specialists are required to request an order number for outpatient elective advanced imaging services regardless of their affiliation with a facility or practice.
Prior to performing an imaging service covered under the program, it is critical that servicing providers confirm an order number has been obtained. Review all CPT codes on your AIM order to confirm the services listed are the ones your facility will provide to the patient. If the services differ from what is listed on the order number, follow up with the ordering physician's office immediately or within two business days after a test is performed. If the services rendered are coded differently than what is authorized on the order number, the services may be denied.
You can confirm an order by calling AIM or checking the ProviderPortal. If an order number has not been obtained, servicing providers should request that the ordering provider contact AIM to obtain one.
Hospital-based servicing providers
Hospital-based imaging providers are strongly encouraged to verify that an order number has been obtained prior to scheduling the procedure.
- Inpatient diagnostic imaging is not included in this program.
- Hospital-based radiologists who only provide professional services are not required to request an order number.
- Non-radiology specialists will be required to request an order number for outpatient elective advanced imaging services regardless of their affiliation with a facility or practice.
- If a patient is seen in an emergency room (ER) and the ER physician refers the patient to return to the hospital at a later date for advanced radiology services through the hospital's outpatient service, an order number must be obtained from AIM.
Diagnostic imaging services included in this program
The following services are included in the program when they are performed in an outpatient, elective setting:
- Nuclear cardiology
- Positron emission tomography (PET) studies
- Magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA)
- Computerized tomography (CT)/computerized tomography angiography (CTA)
- Stress echocardiography (SE)/resting transthoracic echocardiography (TTE)/transesophageal echocardiography (TEE)
View a complete list of codes that are included in this program on our pre-authorization lists.
Note: A procedure being done for mapping and planning for surgery requires an order number from AIM.
Diagnostic imaging services excluded from this program
Order numbers are not required for services performed at the following locations:
- Hospital observation
- Inpatient hospitalization
- Emergency room (ER) visits
- Contracted urgent care centers
- Outpatient surgery (hospital or free-standing surgery centers)
The following diagnostic imaging services are excluded from the program but still require pre-authorization:
- Virtual colonoscopy
- Magnetic resonance spectroscopy (MRS)
- Coronary computerized tomography angiography (CCTA)
Urgent care services and the need for an order number
- If the patient is referred by an urgent care provider to the ER for advanced diagnostic imaging services, an order number from AIM is not needed.
- If a patient is referred by an urgent care provider to a free-standing imaging center or the hospital's outpatient service department for advanced diagnostic imaging services, an order number from AIM is needed.
Obtaining retrospective order number no longer accepted
We do not accept retrospective requests for an order number for any reason. Emergency room services do not require an order number. Outpatient elective diagnostic imaging services are typically non-urgent in nature and an order number can be obtained through AIM's ProviderPortal or by contacting AIM's call center at 1 (877) 291-0509.