This communication applies to the Medicaid, Medicare Advantage and Medicare-Medicaid Plan (MMP) programs for Anthem Blue Cross (Anthem).

In the December 2020 edition of Provider News, Anthem  indicated the transition of the clinical criteria for medical necessity review of CG-SURG-74 Total Ankle Replacement services to AIM Specialty Health small joint guidelines would be effective February 4, 2020. The actual effective date is February 4, 2021.

These reviews will continue to be completed by the Anthem Utilization Management team.

 

You may access and download a copy of the AIM Small Joint Guidelines here.

 

We apologize for any confusion this error may have caused.

 

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Featured In:
January 2021 Anthem Blue Cross Provider News - California