Policy Updates Medical Policy & Clinical GuidelinesCommercialJune 30, 2019

Un-adopted clinical guidelines effective June 1, 2019

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

(The following guidelines are no longer adopted.)
  • CG-DME-07-Augmentative and Alternative Communication (AAC) Devices/Speech Generating Devices (SGD)
  • CG-MED-70-Wireless Capsule Endoscopy for Gastrointestinal Imaging and the Patency Capsule
  • CG-MED-72-Hyperthermia for Cancer Therapy
  • CG-SURG-24-Functional Endoscopic Sinus Surgery (FESS)
  • CG-SURG-70-Gastric Electrical Stimulation
  • CG-SURG-73-Balloon Sinus Ostial Dilation
  • CG-SURG-76-Carotid, Vertebral and Intracranial Artery Stent Placement with or without Angioplasty
  • CG-THER-RAD-04-Selective Internal Radiation Therapy (SIRT) of Primary or Metastatic Liver Tumors

PUBLICATIONS: July 2019 Empire Provider News