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Clinical Policy Updates
Ambetter of Tennessee continuously updates select clinical policies each month. This page reflects upcoming clinical policy changes. Please refer to this page for recent policy updates and reach out to your Provider Relations representative if you have any questions.
- Bariatric Surgery (CP.MP.37) (PDF)
- Behavioral Health Treatment Documentation Requirements (HIM.CP.BH.500) (PDF)
- Concert Genetic Testing: Aortopathies and Connective Tissue Disorders (V2.2024) (PDF)
- Concert Genetic Testing: Cardiac Disorders (V2.2024) (PDF)
- Concert Genetic Testing: Dermatologic Conditions (V2.2024) (PDF)
- Concert Genetic Testing: Epilepsy, Neurodegenerative, and Neuromuscular Conditions (V2.2024) (PDF)
- Concert Genetic Testing: Exome and Genome Sequencing for the Diagnosis of Genetic Disorders (V2.2024) (PDF)
- Concert Genetic Testing: Eye Disorders (V2.2024) (PDF)
- Concert Genetic Testing: Gastroenterologic Disorders (non-cancerous) (V2.2024) (PDF)
- Concert Genetic Testing: General Approach to Genetic and Molecular Testing (V2.2024) (PDF)
- Concert Genetic Testing: Hearing Loss (V2.2024) (PDF)
- Hematologic Conditions (non-cancerous) (V2.2024) (PDF)
- Concert Genetic Testing: Hereditary Cancer Susceptibility (V2.2024) (PDF)
- Concert Genetic Testing: Immune, Autoimmune, and Rheumatoid Disorders (V2.2024) (PDF)
- Concert Genetic Testing: Kidney Disorders (V2.2024) (PDF)
- Concert Genetic Testing: Lung Disorders (V2.2024) (PDF)
- Concert Genetic Testing: Metabolic, Endocrine, and Mitochondrial Disorders (V2.2024) (PDF)
- Concert Genetic Testing: Multisystem Inherited Disorders, Intellectual Disability, and Developmental Delay (V2.2024) (PDF)
- Concert Genetic Testing: Non-invasive Prenatal Screening (NIPS) (V2.2024) (PDF)
- Concert Genetic Testing: Pharmacogenetics (V2.2024) (PDF)
- Concert Genetic Testing: Preimplantation Genetic Testing (V2.2024) (PDF)
- Concert Genetic Testing: Prenatal and Preconception Carrier Screening (V2.2024) (PDF)
- Concert Genetic Testing: Prenatal Diagnosis (via Amniocentesis, CVS, or PUBS) and Pregnancy Loss (V2.2024) (PDF)
- Concert Genetic Testing: Skeletal Dysplasia and Rare Bone Disorders (V2.2024) (PDF)
- Concert Genetics Oncology: Algorithmic Testing (V2.2024) (PDF)
- Concert Genetics Oncology: Cancer Screening (V2.2024) (PDF)
- Concert Genetics Oncology: Circulating Tumor Cells (Liquid Biopsy) (V2.2024) (PDF)
- Concert Genetics Oncology: Cytogenetic Testing (V2.2024) (PDF)
- Concert Genetics Oncology: Molecular Analysis of Solid Tumors and Hematologic Malignancies (V2.2024) (PDF)
- Deep Transcranial Magnetic Stimulation for Treatment of Obsessive Compulsive Disorder (CP.BH.201) (PDF)
- Donor Lymphocyte Infusion (CP.MP.101) (PDF)
- Experimental Technologies (CP.MP.36) (PDF)
- Hyperhidrosis Treatments (CP.MP.62) (PDF)
- Implantable Wireless Pulmonary Artery Pressure Monitoring (CP.MP.160) (PDF)
- Infectious Disease: Dermatologic Lab Testing (CG.CP.MP.03) (PDF)
- Infectious Disease: Gastroenterologic Lab Testing (CG.CP.MP.04) (PDF)
- Infectious Disease: Genitourinary Lab Testing (CG.CP.MP.07) (PDF)
- Infectious Disease: Multisystem Lab Testing (CG.CP.MP.02 ) (PDF)
- Infectious Disease: Primary Care & Preventive Lab Screening (CG.CP.MP.05) (PDF)
- Infectious Disease: Vector-borne and Tropical Diseases Lab Testing (CG.CP.MP.06) (PDF)
- Intensity-Modulated Radiotherapy (CP.MP.69) (PDF)
- Lung Transplantation (CP.MP.57) (PDF)
- Nerve Blocks and Neurolysis for Pain Management (CP.MP.170) (PDF)
- Pediatric Kidney Transplant (CP.MP.246) (PDF)
- Preventative Health and Clinical Practice Guideline Policy and CPG Grid (CP.CPC.03) (PDF)
- Outpatient Cardiac Rehabilitation (CP.MP.176) (PDF)
- Sclerotherapy and Chemical Endovenous Ablation for Varicose Veins and Other Symptomatic Venous Disorders (CP.MP.146) (PDF)
- Short Inpatient Hospital Stay (CP.MP.182) (PDF)
- Skilled Nursing Facility Leveling (CC.PP.206) (PDF)
- Skin and Soft Tissue Substitutes for Chronic Wounds (CP.MP.185) (PDF)
- Transcranial Magnetic Stimulation for Treatment Resistant Major Depression (CP.BH.200) (PDF)
- Wheelchair Seating (CP.MP.99) (PDF)
- Bone-Anchored Hearing Aid (CP.MP.93) (PDF)
- Biofeedback for Behavioral Health Disorders (CP.BH.300) (PDF)
- Disc Decompression Procedures (CP.MP.114) (PDF)
- Durable Medical Equipment and Orthotics and Prosthetics Guidelines (CP.MP.107) (PDF)
- Facet Joint Interventions (CP.MP.171) (PDF)
- Fetal Surgery in Utero for Prenatally Diagnosed Malformations (CP.MP.129) (PDF)
- Home Ventilators (CP.MP.184) (PDF)
- Hospice Services (CP.MP.54) (PDF)
- Reduction Mammoplasty and Gynecomastia Surgery (CP.MP.51) (PDF)
- Sacroiliac Joint Fusion (CP.MP.126) (PDF)
- Spinal Cord, Peripheral Nerve, and Percutaneous Electrical Nerve Stimulation (CP.MP.117) (PDF)