State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageSeptember 1, 2019

Customizations to the 23rd edition of the MCG Care Guidelines

Medicare Advantage


Effective November 1, 2019, customizations will be implemented for Chemotherapy and Inpatient & Surgical Care (W0162) for adult patients. The customizations provide specific criteria and guidance on the following:

 

  • Clinical indications for admission; examples will also be added for:


          o Aggressive hydration needs that cannot be managed in an infusion center

          o Prolonged marrow suppression.

 

  • Regimens that cannot be managed outpatient; examples will also be added.

 

Providers can view a summary of the 23rd edition of the MCG Care Guidelines customizations online by selecting Customizations to MCG Care Guidelines 23rd Edition.

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