Clinical utilization management guideline update

Anthem Blue Cross and Blue Shield and our affiliate HealthKeepers, Inc. are committed to reducing costs while improving health outcomes. To that end, CG-SURG-49 Endovascular Techniques (Percutaneous or Open Exposure) for Arterial Revascularization of the Lower Extremities was implemented as of May 1, 2016, with the review of specific diagnosis per the medical necessity criteria.

 

Effective January 1, 2022, additional diagnosis will be added to the review process. The CPT codes associated with this clinical UM guideline are 37220, 37221, 37222, 37223, 37224, 37225, 37226, 37227, 37228, 37229, 37230, 37231, 37232, 37233, 37234, 37235, 0505T, and 0620T.

 

1346-1021-PN-VA