Ambetter Clinical Coverage/Medical Policy Updates
Ambetter from Arkansas Health & Wellness updates a select number of clinical coverage policies each month, ensuring the reviewal of all policies on an annual basis.
Provider Notification
Ambetter from Arkansas Health and Wellness is amending or implementing new policies. Please see the table below for a list of these policies and their effective dates.
CP.MP.247 - Transplant Service Documentation Requirements (PDF)
CP.MP.14 - Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention (PDF)
CP.MP.185 - Skin and Soft Tissue Substitutes for Chronic Wounds (PDF)
HIM.CP.BH.500 - Behavioral Health Treatment Documentation Requirements (PDF)
AR.CP.MP.184 - Home Ventilators (PDF)
CP.MP.150 - Phototherapy for Neonatal Hyperbilirubinemia (PDF)
CP.MP.180 - Implantable Hypoglossal Nerve Stim (PDF)
CP.MP.194 - Osteogenic Stimulation (PDF)
CP.MP.54 - Hospice Services (PDF)
CP.MP.81 - NICU Discharge Guidelines (PDF)
CP.MP.82 - NICU Apnea Bradycardia Guidelines (PDF)
CP.MP.85 - Neonatal Sepsis Management Guidelines (PDF)
CP.MP.249 - Allogeneic Hematopoietic Progenitor Cell Therapy (PDF)
CP.MP.127 - Total Artificial Heart (PDF)
CP.MP.137 - Fecal Incontinence Treatments (PDF)
CP.MP.51 - Reduction Mammoplasty and Gynecomastia Surgery (PDF)
AR.CP.MP.501 - ABI (subacute and chronic) Inpatient Neurorehabilitation (PDF)
CP.VP.06 - Medically Necessary Hardware
CP.VP.13 - Preventive (Routine) Eye Examination
CP.VP.13 - Attachment A Refractive Hardware
CP.VP.14 - Scanning Computerized Ophthalmic Diagnostic Imaging
CP.VP.26 - Extended Ophthalmoscopy
CP.VP.28 - Fluorescein Angiography
CP.VP.29 - Fundus Photography
CP.VP.31 - Gonioscopy
CP.VP.43 - External Ocular Photography
CP.VP.63 - Visual Field Testing