CLINICAL APPROPRIATENESS GUIDELINES

ADVANCED IMAGING - aimspecialtyhealth.com

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Musculoskeletal Program Clinical Appropriateness ...

Appropriate.Safe.Affordable © 2019 AIM Specialty Health 2063-0119 V.3 Spine Surgery Guidelines Musculoskeletal Program Clinical Appropriateness Guidelines

  Surgery

ADVANCED IMAGING - aimspecialtyhealth.com

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  Advanced, Imaging, Advanced imaging

ADVANCED IMAGING

herein or not contained herein. The following code list is not meant to be all-inclusive. Authorization requirements will vary by health plan. Please consult the applicable health plan for guidance on specific procedure codes. Specific CPT codes for …

  Code, Lists, Contained

ADVANCED IMAGING - AIM Specialty Health

Magnetic resonance imaging (MRI) is preferable to CT in most clinical scenarios. It is the study of choice for visualization of brain parenchyma and white matter tracts. It is also preferred for imaging of the posterior fossa and brainstem structures. Standard anatomic coverage of head MRI is from the base of

  Imaging, Magnetic, Resonance, Magnetic resonance imaging

ADVANCED IMAGING

• To encourage standardization of medical practice patterns ... conversation, factors such as patient acuity and setting of service may also be taken into account. ... MRI is usually preferred over CT for evaluation of the sella turcica and visual pathways. For imaging of the

  Visual, Acuity, Standardization

ADVANCED IMAGING

especially in the right upper quadrant and in the pelvis and especially in pediatric patients and pregnant women. Computed tomography (CT) is often utilized for imaging the abdomen and pelvis. It provides excellent 3-

  Tomography, Abdomen, Computed, Computed tomography, Pelvis, The abdomen and pelvis

MUSCULOSKELETAL PROGRAM

MUSCULOSKELETAL PROGRAM Appropriate Use Criteria: Interventional Pain Management EFFECTIVE NOVEMBER 7, 2021 Proprietary ... o Physician or physical therapist-supervised home treatment program which may include flexibility and muscle strengthening exercises

  Programs, Management, Pain, Musculoskeletal, Pain management, Musculoskeletal program

Clinical Appropriateness Guidelines: Advanced Imaging

CT of cervical spine, without contrast, followed by re-imaging with contrast Standard Anatomic Coverage Entire cervical spine (C1-C7), from the craniocervical junction through the T1 vertebra Axial images are routinely obtained, with capability for coronal and sagittal reconstructions

  Without, Spine, Cervical, Contrast, Cervical spine, Without contrast

ADVANCED IMAGING - AIM Specialty Health

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  Imaging

Clinical Appropriateness Guidelines: Advanced Imaging

“Guidelines”) are designed to assist providers in making the most appropriate treatment decision for a specific clinical condition for an individual. As used by AIM, the Guidelines establish objective and evidence-based, where possible, criteria for medical necessity determinations. In the process, multiple functions are accomplished:

  Guidelines, Medical, Criteria, Necessity, Medical necessity

Speech-Language Pathology Medical Review Guidelines

Speech-Language Pathology Medical Review Guidelines 3 Introduction The purpose of the medical review guidelines for speech-language pathology is to serve as a resource for health plans to use in all facets of claims review and policy development. The guidelines provide an overview of the profession of speech-language pathology including

  Guidelines, Medical

Medical Necessity Criteria

Medical Necessity Please refer to the controlling specific health plan and/or group documents for the definition of Medical Necessity. An internal New Directions committee of behavioral health practitioners and psychiatrists developed the Medical Necessity Criteria (“Criteria” or “MNC”) contained in this document. A panel of external,

  Medical, Criteria, Necessity, Medical necessity, Medical necessity criteria

CIGNA STANDARDS AND GUIDELINES/MEDICAL …

ASAM Criteria for Substance Use Disorders and developed our Standards and Guidelines - Medical Necessity Criteria for Treatment of Mental Health Disorders. These Criteria are intended to be working documents to help set expectations and facilitate a shared responsibility.

  Guidelines, Standards, Medical, Criteria, Necessity, Cigna, Cigna standards and guidelines medical, Standards and guidelines medical necessity criteria

Magellan Healthcare, Inc.* 2021 2022 Magellan Care Guidelines

2021 – 2022 Magellan Care Guidelines 3 Preamble - Principles of Medical Necessity Determinations Magellan uses MCG Guidelines®, along with its proprietary clinical criteria, Magellan Healthcare Guidelines, as the primary decision support tools for our Utilization Management Program.

  Guidelines, Medical, Criteria, Necessity, Medical necessity

Medically Necessary Orthodontic Treatment – Dental ...

In accordance with Generally Accepted Standards of Medical Practice. Clinically appropriate, in terms of type, frequency, extent, site and duration, and considered effective for your sickness, injury, mental illness, substance use disorder, disease or its symptoms. Not mainly for your convenience or that of your doctor or other health care ...

  Standards, Medical

2020-2021 NIA Clinical Guidelines for Medical Necessity …

Guidelines for Clinical Review Determination Preamble Magellan is committed to the philosophy of supporting safe and effective treatment for patients. The medical necessity criteria that follow are guidelines for the provision of diagnostic imaging. These criteria are designed to guide both providers and reviewers to the most

  Guidelines, Medical, Criteria, Necessity, Medical necessity, Medical necessity criteria