Anthem customizations to MCG care guidelines 23rd edition*

Effective November 1, 2019, the following MCG care guideline 23rd edition customization will be implemented for Chemotherapy, Inpatient & Surgical Care (W0162) for adult patients. This customization provides specific criteria and guidance on the following:

• Revised Clinical Indications for admission and added examples for:
  • o Aggressive hydration needs that cannot be managed in an infusion center
  • o Prolonged marrow suppression
• Added Regimens that cannot be managed as an outpatient with examples

 

Click here to view the summary of MCG 23RD edition customizations.

For questions, please contact the provider service number on the back of the member's ID card.

 

^{* Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.}