Medical Policy and Clinical UM Guidelines notification

Anthem Blue Cross and Blue Shield (Anthem) and our subsidiary company, HMO Nevada, are pleased to provide you with our updated and new Medical Policies. Anthem will also be implementing changes to our Clinical Utilization Management (UM) Guidelines that are adopted for Nevada. The Clinical UM Guidelines published on our website represent the Clinical UM Guidelines currently available to all plans for adoption throughout our organization. Because local practice patterns, claims systems and benefit designs vary, a local plan may choose whether to implement a particular Clinical UM Guideline. The link below can be used to confirm whether the local Plan has adopted the Clinical UM Guideline(s) in question. Adoption lists are created and maintained solely by each local plan.

The major new policies and changes are summarized below. Please refer to the specific policy for coding, language, and rationale updates and changes that are not summarized in the attachment.