Blue Cross Anthem (California) Updated Medical Policy 4/2009

Anthem BX HBO Medical Policy April 22 2009

Note that there is an additional indication of “Central retinal artery occlusion” (CRAO) added to the list of medically necessary indications.

Another noticeable change is that Blue Cross of California has “REMOVED” acute osteomyelitis and “REPLACED” it with chronic refractory osteomyelitis.

They have also added a more definitive description of “Chronic non-healing wounds” classified under “Arterial Insufficiencies” to include the following wounds:

a. Diabetic wounds of the lower extremity (Wagner 3 and above)

b. Arterial insufficiency ulcers.

c. Pressure ulcers – with special circumstances (read the policy carefully). Decubitus ulcers are not recommended.

d. Venous stasis ulcers – with special circumstances (read the policy carefully).

I hope this is helpful.

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One thought on “Blue Cross Anthem (California) Updated Medical Policy 4/2009

  1. This is very helpful. Thank you. I have had a lot of denials from Anthem Blue Cross – even when we follow the medical policy. Has anyone experienced this at all?

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