Medical Policy and Clinical Guideline updates

The following revised Medical Policies and Clinical Guidelines were endorsed at the May 30, 2024, and June 6, 2024, Medical Policy & Technology Assessment Committee (MPTAC) meetings. These, 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

Revised Medical Policy effective November 1, 2024

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

• MED.00055 Wearable Cardioverter Defibrillators

Clinical Guideline updates

Revised Clinical Guideline effective November 1, 2024

The following adopted guideline was revised and might result in services that were previously covered but may now be found to be not medically necessary:

• CG-MED-59 Upper Gastrointestinal Endoscopy in Adults