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.132 - Heart-Lung Transplant (PDF)
CP.MP.24 - Multiple Sleep Latency Testing (PDF)
CP.MP.58 - Intestinal and Multivisceral Transplant (PDF)
CP.MP.87 - Therapeutic Utilization of Inhaled Nitric Oxide (PDF)
CP.MP.12 - Vagus Nerve Stimulation (PDF)
CP.MP.133 - Posterior Tibial Nerve Stimulation for Voiding Dysfunction (PDF)
CP.MP.167 - Intradiscal Steroid Injections for Pain Management (PDF)
CP.MP.169 - Trigger Point Injections for Pain Management (PDF)
CP.MP.203 - Diaphragmatic Phrenic Nerve Stimulation (PDF)
CP.MP.247 - Transplant Service Documentation Requirements (PDF)
CP.MP.250 - Lantindra (donislecel) Allogeneic Pancreatic Islet Cellular Therapy (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 (PDF)
CP.VP.13 - Preventive (Routine) Eye Examination (PDF)
CP.VP.13 - Attachment A Refractive Hardware (PDF)
CP.VP.14 - Scanning Computerized Ophthalmic Diagnostic Imaging (PDF)
CP.VP.26 - Extended Ophthalmoscopy (PDF)
CP.VP.28 - Fluorescein Angiography (PDF)
CP.VP.29 - Fundus Photography (PDF)
CP.VP.31 - Gonioscopy (PDF)
CP.VP.43 - External Ocular Photography (PDF)
CP.VP.63 - Visual Field Testing (PDF)