Coverage guidelines effective July 1, 2022

Anthem Blue Cross and Blue Shield in Virginia and our affiliate, HealthKeepers, Inc., will implement the following new and revised coverage guidelines effective July 1, 2022.  These guidelines impact all our products – with the exception of Anthem HealthKeepers Plus (Medicaid), Medicare Advantage, the Commonwealth Coordinated Care Plus (Anthem CCC Plus) plan, and the Blue Cross and Blue Shield Service Benefit Plan (also called the Federal Employee Program® or FEP®).  Furthermore, the guidelines were among those recently approved at the Medical Policy and Technology Assessment Committee meeting held on February 17, 2022.

 

The services addressed in these coverage guidelines here and in the attachment under "Article Attachments" to the right will require authorization for all of our HealthKeepers, Inc. products – with the exception of Anthem HealthKeepers Plus (Medicaid), Medicare Advantage and the Commonwealth Coordinated Care Plus (Anthem CCC Plus) plan. A pre-determination can be requested for our PPO products. Please note that FEP is excluded from this requirement as well.

 

The guidelines addressed in this edition of Provider News are:

• Immune Biomarker Tests for Cancer (LAB.00043)
• Saliva-based Testing to Determine Drug-Metabolizer Status (LAB.00044)
• Selected Tests for the Evaluation and Management of Infertility (LAB.00045)
• Quantitative Ultrasound for Tissue Characterization (RAD.00067)
• Microsurgical Procedures for the Prevention or Treatment of Lymphedema (SURG.00154)
• Implanted Port Delivery System to Treat Ocular Disease (SURG.00160)
• Thymus Tissue Transplantation (TRANS.00038)

 

1407-0422-PN-VA