Coverage guideline effective November 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  November 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 May 12, 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:

• Intermittent abdominal pressure ventilation devices (DME.00046)
• Rehabilitative devices with remote monitoring (DME.00047)
• Virtual reality-assisted therapy systems (DME.00048)
• Gene expression profiling of melanomas and cutaneous squamous cell carcinoma (GENE.00023)
• Hybrid personalized molecular residual disease testing for cancer (GENE.00059)
• Pain management biomarker analysis (LAB.00048)
• Electrical impedance scanning for cancer detection (MED.00139)
• Portable normothermic organ perfusion system (TRANS.00039)
• Cryosurgical, radiofrequency or laser ablation to treat solid tumors outside the liver (CG-SURG-61)

VABCBS-CM-003254-22