Carelon Medical Benefits Management, Inc. updates

Effective April 1, 2024, Anthem will transition to the following Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines for medical necessity/clinical appropriateness reviews for requested interventions:

• Genetic Testing Guidelines:
  • Carrier Screening in the Prenatal Setting and Preimplantation Genetic Testing
  • Cell-free DNA Testing for the Management of Cancer
  • Chromosomal Microarray Analysis
  • Genetic Testing for Inherited Conditions
  • Hereditary Cancer Testing
  • Pharmacogenomic Testing
  • Polygenic Risk Scores
  • Prenatal Testing using cell-free DNA
  • Somatic Tumor Testing
  • Whole Exome Sequencing and Whole Genome Sequencing