Medical Policy and Clinical Guideline updates

The following new Medical Policies were endorsed at the February 15, 2024, Medical Policy & Technology Assessment Committee (MPTAC) meeting. This, and all Anthem’s Medical Policies and Clinical Guidelines, are available at anthem.com. Select For Providers. Under the Provider Resources heading, select Policies, Guidelines & Manuals. Select your state. Then, select View Medical Policies & Clinical UM Guidelines.

To view Medical Policies and Clinical Utilization Management Guidelines applicable to members enrolled in the Blue Cross and Blue Shield service benefit plan (commonly referred to as the Federal Employee Program^® FEP), visit fepblue.org > Policies & Guidelines.

Medical Policy updates

New Medical Policies effective August 1, 2024

The following policies are new:

• OR-PR.00008 Osseointegrated Limb Prostheses
• SURG.00162 Implantable Shock Absorber for Treatment of Knee Osteoarthritis

Revised Medical Policies effective August 1, 2024

The policies below were revised and might result in services that were previously covered but may now be found to be either not medically necessary and/or investigational:

• ANC.0008 Cosmetic and Reconstructive Services of the Head and Neck
• LAB.00039 Combined Pathogen Identification and Drug Resistance Testing
• SURG.00052 Percutaneous Vertebral Disc and Vertebral Endplate Procedures
• SURG.00135 Renal Sympathetic Nerve Ablation