| CG-SURG-78 Locoregional Techniques for Treating Primary and Metastatic Liver Malignancies | CG-SURG-78 · Commercial | 7 | Original policy ↗ |
| CG-SURG-79 Implantable Infusion Pumps | CG-SURG-79 · Commercial | 18 | Original policy ↗ |
| CG-SURG-81 Cochlear Implants and Auditory Brainstem Implants | CG-SURG-81 · Commercial | 8 | Original policy ↗ |
| CG-SURG-82 Bone-Anchored and Bone Conduction Hearing Aids | CG-SURG-82 · Commercial | 13 | Original policy ↗ |
| CG-SURG-83 Bariatric Surgery and Other Treatments for Clinically Severe Obesity | CG-SURG-83 · Commercial | 27 | Original policy ↗ |
| CG-SURG-84 Mandibular/Maxillary (Orthognathic) Surgery | CG-SURG-84 · Commercial | 45 | Original policy ↗ |
| CG-SURG-88 Mastectomy for Gynecomastia | CG-SURG-88 · Commercial | 2 | Original policy ↗ |
| CG-SURG-89 Radiofrequency Neurolysis and Pulsed Radiofrequency Therapy for Trigeminal Neuralgia | CG-SURG-89 · Commercial | 6 | Original policy ↗ |
| CG-SURG-90 Mohs Micrographic Surgery | CG-SURG-90 · Commercial | 5 | Original policy ↗ |
| CG-SURG-91 Minimally Invasive Ablative Procedures for Epilepsy | CG-SURG-91 · Commercial | 4 | Original policy ↗ |
| CG-SURG-92 Paraesophageal Hernia Repair | CG-SURG-92 · Commercial | 8 | Original policy ↗ |
| CG-SURG-99 Panniculectomy and Abdominoplasty | CG-SURG-99 · Commercial | 5 | Original policy ↗ |
| CG-THER-RAD-07 Intravascular Coronary and Non-Coronary Brachytherapy | CG-THER-RAD-07 · Commercial | 6 | Original policy ↗ |
| CG-TRANS-02 Kidney Transplantation | CG-TRANS-02 · Commercial | 12 | Original policy ↗ |
| CG-TRANS-03 Donor Lymphocyte Infusion for Hematologic Malignancies after Allogeneic Hematopoietic Progenitor Cell Transplantation | CG-TRANS-03 · Commercial | 2 | Original policy ↗ |
| Claims Requiring Additional Documentation – Professional and Facility | C-22001 · Effective Mar 23, 2022 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Clinic Charges – Facility | C-14002 · Effective Jul 21, 2025 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Clinical Data Sharing | Commercial · CT, GA, ME, NH, NV, NY, VA | — | Original policy ↗ |
| Clinical Information Required for Claim Adjudication | R05031 · Commercial · ME | — | Original policy ↗ |
| Clinical UM Guidelines adopted by Anthem Blue Cross and Blue Shield in Maine | ME-BCBS-CM-019295-26-S5049 · Commercial · ME | 66 | Original policy ↗ |
| CMS 1500 (version 08/05) Paper Claim Filing Instructions | Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| Coblation® Therapies for Musculoskeletal Conditions | SURG.00088 · Commercial | 2 | Original policy ↗ |
| Code and Clinical Editing Guidelines – Professional and Facility | C-25002 · Effective Oct 1, 2025 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Commercial Medical Record Standards | Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| Commercial Medical Record Standards | Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| Commercial Risk Adjustment Coding Guide | Commercial · CO, CT, GA, IN, KY, ME, MO, NH, OH, VA, WI | — | Original policy ↗ |
| Complaints and Appeals Information | Commercial · ME | — | Original policy ↗ |
| Consultation Services – Professional | C-09010 · Effective Dec 29, 2023 · Commercial · ME | 10 | Original policy ↗ |
| Coordination of Care Information | Commercial · ME | — | Original policy ↗ |
| COPD Patient Flyer | Commercial · CT, ME, NH | — | Original policy ↗ |
| Critical Care to Home – Facility | C-25004 · Effective Apr 1, 2026 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 6 | Original policy ↗ |
| Cryoablation for Plantar Fasciitis and Plantar Fibroma | SURG.00100 · Commercial | 2 | Original policy ↗ |
| Cryosurgical, Radiofrequency, Microwave or Laser Ablation to Treat Solid Tumors Outside the Liver | CG-SURG-61 · Commercial | 25 | Original policy ↗ |
| Deep Brain Stimulation and Responsive Neurostimulation | SURG.00026 · Commercial | 22 | Original policy ↗ |
| Dental claims review submission requirements | Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | 125 | Original policy ↗ |
| Dental Web Portal Notification | Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| Destruction of Pre-Malignant Skin Lesions | CG-SURG-37 · Commercial | 3 | Original policy ↗ |
| Diabetes Patient Flyer | Commercial · CT, ME, NH | — | Original policy ↗ |
| Diagnostic Radiopharmaceuticals and Contrast Materials - Professional and Facility | C-24001 · Effective May 1, 2025 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 6 | Original policy ↗ |
| Discharge Planning Guideline | Commercial · ME, NH | — | Original policy ↗ |
| DME Modifiers - Professional | C-19006 · Effective Sep 28, 2022 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | — | Original policy ↗ |
| DME.00012 Intrapulmonary Percussive Ventilation Devices | DME.00012 · Commercial | 1 | Original policy ↗ |
| DME.00022 Functional Electrical Stimulation (FES); Threshold Electrical Stimulation (TES) | DME.00022 · Commercial | 5 | Original policy ↗ |
| DME.00030 Altered Auditory Feedback Devices for Fluency Disorders | DME.00030 · Commercial | 1 | Original policy ↗ |
| DME.00037 Cooling Devices and Combined Cooling/Heating Devices | DME.00037 · Commercial | 6 | Original policy ↗ |
| DME.00038 Static Progressive Stretch (SPS) and Patient-Actuated Serial Stretch (PASS) Devices | DME.00038 · Commercial | 9 | Original policy ↗ |
| DME.00046 Intermittent Abdominal Pressure Ventilation Devices | DME.00046 · Commercial | 1 | Original policy ↗ |
| DME.00047 Rehabilitative Devices with Remote Monitoring | DME.00047 · Commercial | 1 | Original policy ↗ |
| DME.00048 Virtual Reality-Assisted Therapy Systems | DME.00048 · Commercial | 7 | Original policy ↗ |
| DME.00049 External Upper Limb Stimulation for the Treatment of Tremors | DME.00049 · Commercial | 2 | Original policy ↗ |
