Nevada
Provider Communications

February 2019 Anthem Provider Newsletter - NV

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Title Category

Use grouped CPT codes for AIM Specialty Health authorizations

Medicare

Updated Escalation Contact List

Administrative

Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred (Professional)

Reimbursement Policies

Significant Edits (Professional)

Reimbursement Policies

Retroactive rate adjustments

Medicaid

Reminder: Review ICD-10-CM Coding Guidelines (Professional)

Reimbursement Policies

Reminder - Anthem follows Original Medicare policies

Medicare

Reimbursement Policies are available online

Reimbursement Policies

Provider and Facility identified Overpayments (aka “voluntary” or “unsolicited”)

Administrative

Prior authorization requirements for Sublocade

Medicaid

Prior authorization requirements for Subcutaneous Implantable Defibrillator system

Medicaid

Pharmacy information available on anthem.com

Pharmacy

New specialty pharmacy medical step therapy requirements

Medicaid

New specialty Medicare Part B device preferred product program

Medicare

My Diverse Patients: a website to support your diverse patients

Medicaid

Member Satisfaction with Behavioral Health Outpatient Services

Behavioral Health

Medical Policies and Clinical Utilization Management Guidelines update

Medicaid

Keep up with Medicare news

Medicare

Introducing a new clinical criteria web page for injectable, infused or implanted drugs covered under the medical benefit

Medicaid

HEDIS 2019 Federal Employee Program® medical record request requirements

Federal Employee Plan (FEP)

Coding spotlight: diabetes - provider guide to coding the diagnosis and treatment of diabetes

Medicaid

Clear Claim Connection: our web-based claim edit tool

Reimbursement Policies

Anthem eye refraction and routine eye exam billing information

Medicare
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