Clinical Utilization Management Guidelines update: March 2018

The Clinical Utilization Management (UM) Guidelines below were developed or revised to support clinical coding edits. Note, several guidelines were revised to provide clarification only and are not included. Existing precertification requirements have not changed.


On March 22, 2018, the Medical Policy and Technology Assessment Committee approved the following Clinical UM Guidelines applicable to Anthem Blue Cross and Blue Shield Medicaid. This list represents the guidelines adopted by the medical operations committee for the Government Business Division on April 19, 2018.

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Featured In:
October 2018 Anthem Kentucky Provider Newsletter