Medical Policy and Clinical Guideline updates

The following new Medical Policies were endorsed at the November 9, 2023, 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 Policy effective May 1, 2024

The following policy is new:

• RAD.00068 Myocardial Strain Imaging*

Revised Medical Policies effective May 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:

• MED.00120 Gene Therapy for Ocular Conditions*
• SURG.00026 Deep Brain, Cortical, and Cerebellar Stimulation*
• SURG.00097 Scoliosis Surgery*
• SURG.00142 Genicular Procedures for Knee Pain*

* The applicable policy is attached to this article in PDF format.