Medical Policy and Clinical Guideline updates

The following new and revised Medical Policies were endorsed at the May 9, 2024, Medical Policy and Technology Assessment Committee (MPTAC) meeting. These policies 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^® or FEP), visit Medical Policies and Utilization Management Guidelines (fepblue.org).

Medical Policy updates

New Medical Policy effective October 1, 2024

The following policy is new:

• RAD.00069 Absolute Quantitation of Myocardial Blood Flow Measurement*

Revised Medical Policies effective October 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.00013 Parenteral Antibiotics for the Treatment of Lyme Disease*
• SURG.00011 Allogeneic, Xenographic, Synthetic, Bioengineered, and Composite Products for Wound Healing and Soft Tissue Grafting*

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