MCG Care Guidelines 24th edition customization
Please note, this communication applies to Anthem HealthKeepers Plus offered by HealthKeepers, Inc.
Effective June 1, 2021, the following new customizations will be implemented:
- Gastrointestinal Bleeding, Upper (W0170, previously ORG M-180) — Customized the Clinical Indications for admission to inpatient care by revising the hemoglobin; systolic blood pressure; pulse; melena; orthostatic hypotension; and BUN criteria.
- Gastrointestinal Bleeding, Upper Observation Care (W0171, previously OCG OC-021) — Customized the Clinical Indications for observation care by revising the systolic blood pressure and hemoglobin criteria and adding melena or hematochezia and suspected history of bleeding.
To access a detailed summary of customizations, select: Customizations to MCG Care Guidelines 24th Edition (path: https://www.anthem.com/provider/policies/clinical-guidelines > Other Criteria > MCG > Customizations to MCG Care Guidelines 24th Edition.)
If you have any questions about this communication, call Provider Services at 1‑800‑901‑0020 or Anthem CCC Plus Provider Services at 1‑855‑323‑4687.
March 2021 Anthem Provider News - Virginia