October 28, 2014 Anthem Blue Cross and Blue Shield (Anthem) will require medical necessity review of cervical fusion procedures Anthem has revised what is reviewed for inpatient and outpatient cervical fusions. The Cervical Fusion clinical review was originally scheduled for implementation on November 5, 2014. The effective date has been changed to December 1, 2014. Prior authorization/precertification is required for all inpatient and outpatient cervical fusions. The cervical fusion codes are listed below. Cervical fusion ICD-9 codes: 81.01, 81.02, 81.03, 81.31, 81.32, 81.33 Cervical fusion CPT codes: 22548, 22551, 22552, 22554, 22590, 22595, 22600 Note: This change does not include National Accounts, Medicare, Medicare Advantage (MA), MMP, and Federal Employee Plan® (FEP). If you have additional questions, please contact your local Network Relations consultant. When a provider recently joins or leaves your practice, or you have a change in your address, phone number, and/or open/close practice status, etc., please let us know by completing the Anthem Provider Maintenance Form at anthem.com. Anthem Blue Cross and Blue Shield is the trade name of: In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Visit us online at www.anthem.com In Ohio: Community Insurance Company. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are the registered marks of the Blue Cross and Blue Shield Association.