BlueCross BlueShield of Tennessee
Modified Utilization Management Guidelines
Search the Modified UM Guidelines

BlueCross BlueShield of Tennessee alters MCG™ when guidelines do not exist for certain conditions, when length of stay needs to be defined, or when consideration is given to prevailing practice in a specific area. The BCBST Modified Utilization Management Guidelines are reviewed annually or if an inquiry is received.

The following guidelines have been revised from MCG™. MCG Health, LLC has neither reviewed nor approved the modified material. Any statement to the contrary or association of the modified material with MCG Health, LLC is strictly prohibited. If you wish to view the complete MCG™, please contact MCG Health, LLC.

Modified UM Guidelines:

Goal Length of Stay Modifications (e.g., ambulatory goal length of stay changed to 23-hr observation)

Listed Alphabetically:

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z (view entire list)

Listed by Conditions:

Cardiology Neurology
Cardiovascular Surgery Neurosurgery
Durable Medical Equipment Obstetrics and Gynecology
Ear, Nose, and Throat Ophthalmology
Endocrinology Orthopedic
Evaluations & Modalities Otolaryngology
Gastroenterology Pediatric
General Surgery Psychiatric
Genetic Medicine Thoracic and Pulmonary
Hematology - Oncology Urology
Musculoskeletal Women's

Additional Listings:

Ambulatory Care
Behavioral Health
Home Care
Home Health (e.g., PDN calculators)
Hospice Care
Inpatient and Surgical Care
Rehabilitative Care (e.g., Inpatient Rehabilitation)

This document has been classified as public information.