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National Imaging Associates (NIA) Annual Clinical Guideline Updates Effective January 2, 2018

Date: 11/14/17

National Imaging Associates (NIA), NH Healthy Families’ radiology benefits manager, has completed their annual clinical guideline review, which involves an extensive clinical review. The guideline changes outlined below are supported by literature reviews and practice experience and are approved by the NIA Chief Medical Officer, Chief Executive Officer and Clinical Guideline Taskforce.

The following guideline changes will be implemented on January 2, 2018:

Global Change to applicable guidelines

·         A follow-up study may be needed to help evaluate a patient’s progress after treatment, procedure, intervention or surgery. Documentation requires a medical reason that clearly indicates why additional imaging is needed for the type and area(s) requested. This was moved from the “Additional Information” section to be included as an approvable indication.

PET scan (Oncology) guideline

·         Clinical indications were added to cover an oncological Gallium 68 Dotatate PET/CT scan.

Cardiac guidelines (Heart (Cardiac) CT, Heart (Cardiac) MRI, Stress Echo, TTE, TEE)

·         Clinical indications added to several of our cardiac guidelines to address valvular heart disease, supported by JU Doherty et al, ACC/AATS/AHA/ASE/ASNC/HRS/SCAI/SCCT/SCMR/STS 2017 Appropriate Use Criteria for Multimodality Imaging in Valvular Heart Disease, JACC, 2017.

On December 4, 2017, NIA will place a link on the www.radmd.com, so that providers can preview the complete set of 2018 advanced imaging clinical guidelines prior to their implementation date of January 2, 2018. Meanwhile, you can continue to view all of your current guidelines at www.radmd.com.

To access the link on radmd, please follow these steps (sign in is not required):

·         www.radmd.com - Home page.

·         Click on the “Solutions” tab from the home page main menu bar.

·         From the “Solutions” drop down list, click on “Advanced Imaging”

·         Click on the link for “Preview of NIA’s 2018 Standard Guidelines”, listed under the Document section.

o   The Table of Contents begins on page 3 of the pdf document.

o   Click once on the study to be viewed.

o   To return to the Table of Contents, click on “TOC” in the upper right hand corner above the heading of each guideline.

Please contact Provider Services at 1-855-769-3085 with any questions.