Coding update effective January 1, 2023

The following guideline was among those recently approved at the Medical Policy and Technology Assessment Committee meeting held August 11, 2022. Revisions have been made to the coding, which may result in services previously considered medically necessary to now be considered not medically necessary for dates of service on or after January 1, 2023.

 

This guideline impacts all our products — excluding Medicare Advantage, Anthem HealthKeepers Plus Medicaid products offered by HealthKeepers, Inc., and the Blue Cross and Blue Shield Service Benefit Plan (also called the Federal Employee Program [FEP]).

 

The services addressed in this guideline will require authorization for all our products, excluding Medicare Advantage, and Anthem HealthKeepers Plus Medicaid products offered by HealthKeepers, Inc. A predetermination can be requested for our PPO products. Please note that FEP is excluded from this requirement as well.

 

Guideline	Code
CG-GENE-13	81309

 

VABCBS-CM-006509-22