This following updates are for Anthem Blue Cross and Blue Shield (Anthem).


Below are updates to medical policies we originally published in the October 2021 edition of Provider NewsThe effective date has changed March 1, 2022 and prior authorization will be required.


Determine if prior authorization is needed for an Anthem member by going to > select “Providers” > under “Claims” > select “Prior Authorization”, then select your state. Or, you may call the prior authorization phone number on the back of the member’s ID card.


*Prior authorization required



Effective Date


TruGraf Blood Gene Expression Test for Transplant Monitoring

TruGraf blood gene expression test is considered investigational and not medically necessary (INV&NMN) for monitoring immunosuppression in transplant recipients and for all other indications

Change to


Serum Biomarker Tests for Risk of Preeclampsia

Serum biomarker tests to diagnosis, screen for, or assess risk of preeclampsia are considered INV&NMN

Change to


Molecular Signature Test for Predicting Response to Tumor Necrosis Factor Inhibitor Therapy

Molecular signature testing to predict response to Tumor Necrosis Factor inhibitor (TNFi) therapy is considered INV&NMN for all uses, including but not limited to guiding treatment for rheumatoid arthritis

Change to


Microprocessor Controlled Knee-Ankle-Foot Orthosis

Outlines the MN and NMN criteria for the use of a microprocessor controlled knee-ankle-foot orthosis

Change to


To view medical policies and 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®)), please visit > Policies & Guidelines. 



Featured In:
December 2021 Anthem Provider News - Missouri