Wisconsin
Provider Communications

Articles Category: Policy Updates / Medical Policy & Clinical Guidelines

Title Publication Category Date

Anthem customizations to MCG care guidelines 23rd edition*

August 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2019

Anthem expands hospice policy

December 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2020

Clinical Guideline Update - May 2019*

May 2019 Anthem Provider Newsletter - Wisconsin Medical Policy & Clinical Guidelines May 1, 2019

Clinical Guideline Updates -- September 2019*

September 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Sep 1, 2019

Clinical practice and preventive health guidelines available on anthem.com

December 2018 Anthem Wisconsin Provider Newsletter Medical Policy & Clinical Guidelines Dec 1, 2018

Clinical practice and preventive health guidelines available on anthem.com

December 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2020

Continuation of skilled nursing facility (SNF) program in Wisconsin

October 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Oct 1, 2021

Correction to Prior Authorization Update for Commercial business*

November 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2020

Expansion of AIM Musculoskeletal Program effective November 1, 2020*

August 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2020

Important Update: Milliman Care Guideline (MCG), 23rd Edition, ORG: W0163 Pelvic Organ Prolapse Repair*

January 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jan 1, 2020

Maximizing efficient, high quality COVID-19 screenings*

*Material Adverse Change (MAC)
COVID-19 Information - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2021

MCG care guidelines 23rd Edition*

May 2019 Anthem Provider Newsletter - Wisconsin Medical Policy & Clinical Guidelines May 1, 2019

MCG Care Guidelines 24th Edition Customization*

January 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jan 1, 2021

MCG Care Guidelines 24th Edition*

April 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2020

MCG Care Guidelines 25th Edition available*

*Material Adverse Change (MAC)
April 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2021

Medical Polices and Clinical Guidelines Updates - December 2018

December 2018 Anthem Wisconsin Provider Newsletter Medical Policy & Clinical Guidelines Dec 1, 2018

Medical policy and clinical guideline updates - April 2021*

*Material Adverse Change (MAC)
April 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2021

Medical policy and clinical guideline updates - August 2020*

August 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2020

Medical policy and clinical guideline updates - December 2020*

December 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2020

Medical policy and clinical guideline updates - December 2021*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2021

Medical Policy and Clinical Guideline Updates - February 2020*

February 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Feb 1, 2020

Medical Policy and Clinical Guideline Updates - February 2021*

February 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Feb 1, 2021

Medical Policy and Clinical Guideline Updates - January 2021*

January 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jan 1, 2021

Medical Policy and Clinical Guideline Updates - July 2021*

*Material Adverse Change (MAC)
July 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jul 1, 2021

Medical Policy and Clinical Guideline Updates - June 2020*

June 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2020

Medical policy and clinical guideline updates - June 2021*

*Material Adverse Change and/or Prior Authorization Change (MAC)
June 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2021

Medical policy and clinical guideline updates - November 2020*

November 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2020

Medical policy and clinical guideline updates - October 2020*

October 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Oct 1, 2020

Medical policy and clinical guideline updates - October 2021*

*Material Adverse Change (MAC)

October 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Oct 1, 2021

Medical Policy and Clinical Guideline Updates -- August 2019*

August 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2019

Medical Policy and Clinical Guideline Updates -- June 2019*

June 2019 Anthem Provider Newsletter - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2019

Medical Policy and Clinical Guidelines Updates

October 2018 Anthem Wisconsin Provider Newsletter Medical Policy & Clinical Guidelines Sep 28, 2018

Medical Policy and Clinical Guidelines Updates - April 2019*

April 2019 Anthem Provider Newsletter - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2019

Medical Policy and Clinical Guidelines Updates -- November 2019*

November 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2019

Medical Policy and Clinical Guidelines: February 2019*

February 2019 Anthem Wisconsin Provider Newsletter Medical Policy & Clinical Guidelines Feb 1, 2019

Modification to voluntary Cancer Care Quality Program (CCQP) enhanced reimbursement to begin July 1, 2021

May 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines May 1, 2021

New Clinical Guideline: Inpatient Inter-Facility Transfers effective September 1, 2019*

June 2019 Anthem Provider Newsletter - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2019

New MCG 24th Edition Guidelines

July 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jul 1, 2020

New prior authorization requirement: Kidney transplantation*

*Material Adverse Change (MAC)
May 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines May 1, 2021

Pre-Service/Prior Authorization Clinical Review Update: February 2019*

February 2019 Anthem Wisconsin Provider Newsletter Medical Policy & Clinical Guidelines Feb 1, 2019

Prior authorization for genetic testing medical policy effective September 1, 2021*

*Material Adverse Change and/or Prior Authorization Change (MAC)
June 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2021

Prior authorization update for Commercial Individual Business*

October 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Oct 1, 2020

REMINDER: AIM Rehabilitative Program Pediatric Exclusions

June 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2020

Reminder: Expansion of AIM Musculoskeletal Program effective November 1, 2020

October 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Oct 1, 2020

Reminder: Post-service reviews using AIM

November 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2020

RETRACTION: AIM Rehabilitative program - initial evaluations and site of service reviews

June 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines May 4, 2021

Transition to AIM rehabilitative service clinical appropriateness guidelines

October 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Oct 1, 2020

Transition to AIM Rehabilitative Services clinical appropriateness guidelines

December 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2020

Transition to AIM Rehabilitative Services Clinical Appropriateness Guidelines*

June 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2020

Transition to AIM Specialty Health imaging of the heart clinical appropriateness guideline for computed tomography to detect coronary artery calcification

August 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2021

Update for Commercial providers: AIM sleep program CPT code E1399, NOC: Durable medical equipment, miscellaneous

April 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2021

Update to AIM Advanced Imaging of the Head and Neck Clinical Appropriateness Guidelines*

April 2019 Anthem Provider Newsletter - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2019

Update to AIM Advanced Imaging of the Heart Clinical Appropriateness Guideline*

April 2019 Anthem Provider Newsletter - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2019

Update to AIM Musculoskeletal Joint Surgery Clinical Appropriateness Guidelines*

April 2019 Anthem Provider Newsletter - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2019

Update to AIM Musculoskeletal Program Clinical Appropriateness Guidelines*

February 2019 Anthem Wisconsin Provider Newsletter Medical Policy & Clinical Guidelines Feb 1, 2019

Update to AIM Sleep Disorder Management Clinical Appropriateness Guidelines*

April 2019 Anthem Provider Newsletter - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2019

Update to AIM Specialty Health oncologic imaging clinical appropriateness guidelines

May 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines May 1, 2021

Update: Clinical guideline adoption postponed*

*Material Adverse Change (MAC)
April 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2021

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations*

July 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jul 1, 2020

UPDATE: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements*

April 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2020

Update: Notice of changes to the AIM Small Joint Surgery guideline

March 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Mar 1, 2021

Updated AIM rehabilitative program effective August 1, 2021 - Initial evaluations and site of service reviews RETRACTION - Please refer to article published May 4, 2021

May 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines May 1, 2021

Updated guidance on prior authorization requirements for admissions to in-network skilled nursing facilities (SNFs)

April 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Apr 1, 2021

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline*

May 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Advanced Imaging clinical appropriateness guideline*

December 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

July 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jul 1, 2019

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

August 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM Advanced Imaging Clinical Appropriateness Guidelines*

February 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Feb 1, 2020

Updates to AIM advanced imaging clinical appropriateness guidelines*

*Material Adverse Change and/or Prior Authorization Change (MAC)
June 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2021

Updates to AIM Advanced Imaging of the Abdomen and Pelvis Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Advanced Oncologic Imaging Clinical Appropriateness Guideline

August 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM Cardiology clinical appropriateness guidelines*

December 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM MSK Interventional Pain Management Clinical Appropriateness Guideline*

May 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines*

February 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Feb 1, 2020

Updates to AIM musculoskeletal program clinical appropriateness guidelines*

*Material Adverse Change and/or Prior Authorization Change (MAC)
June 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Jun 1, 2021

Updates to AIM Musculoskeletal Program Joint Surgery Clinical Appropriateness Guidelines*

May 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Radiation Oncology clinical appropriateness guideline*

December 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM Radiation Oncology: Proton Beam Therapy Clinical Appropriateness Guideline

August 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Aug 1, 2019

Updates to AIM Radiation Therapy Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2019

Updates to AIM Sleep Disorder Management Clinical Appropriateness Guideline*

May 2020 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines May 1, 2020

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management Clinical Appropriateness Guideline*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Spine Surgery Clinical Appropriateness Guideline*

November 2019 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Nov 1, 2019
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