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BCBS – Medical Policy and Clinical Guideline Updates – February 2021
February 8, 2021Feb 1, 2021 • Policy Updates / Medical Policy & Clinical Guidelines
The following Anthem Blue Cross and Blue Shield medical polices will require prior authorization for Indiana, Kentucky, Missouri, Ohio and Wisconsin.
NOTE *Precertification required
| Title | Information | Effective Date |
| *GENE.00055 Gene Expression Profiling for Risk Stratification of Inflammatory Bowel Disease (IBD) Severity |
Gene expression profiling for risk stratification of inflammatory bowel disease (IBD) severity, including use of PredictSURE IBD, is considered Investigational and not medically necessary (INV&NMN) for all indications. CPT PLA code 0203U (effective 10/01/2020) will be considered INV&NMN; also listed NOC codes 81479, 81599 considered NMN when specified as this test. |
5/1/2021 |