Nevada
Provider Communications

Articles Category: Policy Updates

Title Publication Category Date

Additional improvements coming to anthem.com regarding Medical Policies and Clinical Guidelines

November 2019 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Nov 1, 2019

AIM Specialty Health Clinical Appropriateness Guidelines update -- Advanced Imaging (MAC)

Material Adverse Change (MAC)
December 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Dec 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- Advanced Imaging (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- Advanced Imaging of the Abdomen and Pelvis (MAC)

Material Adverse Change (MAC)
November 2019 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Nov 1, 2019

AIM Specialty Health Clinical Appropriateness Guidelines update -- Advanced Imaging: Vascular Imaging (MAC)

Material Adverse Change (MAC)
February 2020 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Feb 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- Cardiology (MAC)

Material Adverse Change (MAC)
December 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Dec 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- MSK Interventional Pain Management (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- Musculoskeletal Program Spine Surgery (MAC)

Material Adverse Change (MAC)
November 2019 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Nov 1, 2019

AIM Specialty Health Clinical Appropriateness Guidelines update -- Musculoskeletal Program: Joint Surgery and Spine Surgery (MAC)

Material Adverse Change (MAC)
February 2020 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Feb 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- Radiation Oncology (MAC)

Material Adverse Change (MAC)
December 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Dec 1, 2020

AIM Specialty Health Clinical Appropriateness Guidelines update -- Radiation Therapy (MAC)

Material Adverse Change (MAC)
November 2019 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Nov 1, 2019

AIM Specialty Health Clinical Appropriateness Guidelines update -- Sleep Disorder Management (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

AIM Specialty Health Clinical Guidelines update - Advanced Imaging (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Aug 1, 2019

AIM Specialty Health Clinical Guidelines update - Advanced Imaging (MAC)

Material Adverse Change (MAC)
July 2019 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Jul 1, 2019

AIM Specialty Health Clinical Guidelines update - Advanced Imaging of the Heart

October 2018 Anthem Important Updates - NV Medical Policy & Clinical Guidelines Oct 1, 2018

AIM Specialty Health Clinical Guidelines update - Musculoskeletal Program

February 2019 Anthem Important Updates - NV Medical Policy & Clinical Guidelines Feb 1, 2019

AIM Specialty Health Clinical Guidelines update - Radiation Oncology

October 2018 Anthem Important Updates - NV Medical Policy & Clinical Guidelines Oct 1, 2018

AIM Specialty Health Clinical Guidelines update - Sleep Disorder Management

October 2018 Anthem Important Updates - NV Medical Policy & Clinical Guidelines Oct 1, 2018

AIM Specialty Health Clinical Guidelines update -- Advanced Imaging of the Head and Neck

April 2019 Anthem Important Updates - Nevada Medical Policy & Clinical Guidelines Apr 1, 2019

AIM Specialty Health Clinical Guidelines update -- Advanced Imaging of the Heart

April 2019 Anthem Important Updates - Nevada Medical Policy & Clinical Guidelines Apr 1, 2019

AIM Specialty Health Clinical Guidelines update -- Musculoskeletal Joint Surgery

April 2019 Anthem Important Updates - Nevada Medical Policy & Clinical Guidelines Apr 1, 2019

AIM Specialty Health Clinical Guidelines update -- Sleep Disorder Management

April 2019 Anthem Important Updates - Nevada Medical Policy & Clinical Guidelines Apr 1, 2019

Ambulance Transportation (Professional Reimbursement Policy - New)

June 2019 Anthem Important Updates - Nevada Reimbursement Policies Jun 1, 2019

Anthem customizations to MCG care guidelines 23rd edition (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Aug 1, 2019

Anthem to enhance claim edits for outpatient facility claims

June 2021 Anthem Provider News - Nevada Reimbursement Policies Jun 1, 2021

Assistant Surgery Services/Code List policy update - Professional

October 2018 Anthem Provider Newsletter - NV Reimbursement Policies Oct 1, 2018

Benefits to be available for chronic care management and advance care planning services effective February 23, 2019

January 2019 Anthem Provider Newsletter - NV Reimbursement Policies Jan 1, 2019

Body Mass Index (BMI) (Facility Reimbursement Policy - Update)

February 2019 Anthem Important Updates - NV Reimbursement Policies Feb 1, 2019

Bundled Services (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Aug 1, 2019

Bundled Services and Supplies (Professional Reimbursement Policy) -- Update

December 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Dec 1, 2020

Bundled Services and Supplies (Professional Reimbursement Policy) – Update (MAC)

Material Adverse Change (MAC)
November 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Nov 1, 2020

Bundled Services and Supplies – Professional

August 2018 Anthem Provider Newsletter - NV Reimbursement Policies Aug 17, 2018

Change notification to medical policies and clinical utilization management guidelines

Material adverse change (MAC)
June 2021 Anthem Provider News - Nevada Medical Policy & Clinical Guidelines Jun 1, 2021

Claim editing update for Excludes1 notes

September 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Sep 1, 2019

Claims editing update for ICD-10-CM Excludes 1 notes

November 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Nov 1, 2020

Claims requiring additional documentation (Facility Reimbursement Policy -- Update for Inpatient and Outpatient) (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies May 1, 2020

Claims requiring additional documentation facility reimbursement policy update

September 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Sep 1, 2019

Clarification: Anthem’s enhanced claim edits for outpatient facility claims

October 2021 Anthem Provider News - Nevada Reimbursement Policies Oct 1, 2021

Clear Claim Connection

October 2018 Anthem Provider Newsletter - NV Reimbursement Policies Oct 1, 2018

Clear Claim Connection

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

Clear Claim Connection

August 2018 Anthem Provider Newsletter - NV Reimbursement Policies Aug 17, 2018

Clear Claim Connection

September 2018 Anthem Provider Newsletter - NV Reimbursement Policies Aug 31, 2018

Clear Claim Connection

January 2019 Anthem Provider Newsletter - NV Reimbursement Policies Jan 1, 2019

Clear Claim Connection: our web-based claim edit tool

February 2019 Anthem Provider Newsletter - NV Reimbursement Policies Feb 1, 2019

Clinic Charges (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Apr 1, 2021

Clinical Laboratory Improvement Amendments (CLIA) claim requirements effective May 1, 2020 (MAC)

Material Adverse Change (MAC)
February 2020 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Feb 1, 2020

Clinical practice and preventive health guidelines available on anthem.com

December 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Dec 1, 2020

Clinical Validation (Professional Reimbursement Policy - Update)

June 2019 Anthem Important Updates - Nevada Reimbursement Policies Jun 1, 2019

CORRECTION: Notice regarding post-pay review of ER claims

CORRECTION: Notice regarding post-pay review of ER claims - Nevada Reimbursement Policies May 16, 2019

Distinctive Procedural Services, Modifiers 59, XE, XP, XS, XU (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
September 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Sep 1, 2020

Documentation Standards for Episodes of Care (Professional Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
November 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Nov 1, 2020

Drug Screen Testing (Professional Reimbursement Policy - Updated)

May 2019 Anthem Provider Newsletter - Nevada Reimbursement Policies May 1, 2019

Emergency Room Transfers (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
February 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Feb 1, 2021

Evaluation and management services correct coding (professional)

Material adverse change (MAC)
June 2021 Anthem Provider News - Nevada Reimbursement Policies Jun 1, 2021

Frequency Editing (Professional Reimbursement Policy - Update)

June 2019 Anthem Important Updates - Nevada Reimbursement Policies Jun 1, 2019

Frequency Editing (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Aug 1, 2019

Frequency Editing (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
September 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Sep 1, 2020

Frequency Editing (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jan 1, 2021

Guidelines for Reporting Timed Units: Physical Medicine and Rehab Services (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jan 1, 2021

ICD-10-CM Coding Guidelines and Laterality: Professional

July 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Jul 1, 2019

Important Update: Milliman Care Guideline (MCG), 23rd Edition, ORG -- W0163 Pelvic Organ Prolapse Repair

March 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Mar 1, 2020

Important Update: Milliman Care Guideline (MCG), 23rd Edition, Pelvic Organ Prolapse Repair (MAC)

Material Adverse Change (MAC)
January 2020 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Jan 1, 2020

Intensity Modulated Radiation Therapy Planning and Delivery (Professional Reimbursement Policy – New) (MAC)

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Sep 1, 2019

Laboratory and Venipuncture Services (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
October 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Oct 1, 2020

Maternity Services and Multiple Delivery (Professional Reimbursement Policies – New) (MAC)

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Sep 1, 2019

MCG care guidelines 23rd Edition and Anthem customizations

May 2019 Anthem Important Updates - Nevada Medical Policy & Clinical Guidelines May 1, 2019

MCG Care Guidelines 24th Edition (MAC)

Material Adverse Change (MAC)
April 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Apr 1, 2020

MCG care guidelines 24th Edition Customization (MAC)

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Jan 1, 2021

MCG Care Guidelines 25th Edition (MAC)

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Apr 1, 2021

Medical Policy and Clinical UM Guideline changes notification letter

March 2019 Anthem Important Updates - NV Medical Policy & Clinical Guidelines Mar 1, 2019

Medical Policy and Clinical UM Guideline changes notification letter

January 2019 Anthem Important Updates - NV Medical Policy & Clinical Guidelines Jan 1, 2019

Medical Policy and Clinical UM Guideline Updates (MAC)

Material Adverse Change (MAC)
February 2021 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Feb 1, 2021

Medical Policy and Clinical UM Guidelines change notification letter

February 2019 Anthem Important Updates - NV Medical Policy & Clinical Guidelines Feb 1, 2019

Medical Policy and Clinical UM Guidelines notification (MAC)

Material Adverse Change (MAC)
December 2019 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Dec 1, 2019

Medical policy and clinical UM guidelines notification (MAC)

Material adverse change (MAC)
October 2021 Anthem Provider News - Nevada Medical Policy & Clinical Guidelines Oct 1, 2021

Medical Policy and Clinical UM Guidelines notification letter

June 2019 Anthem Important Updates - Nevada Medical Policy & Clinical Guidelines Jun 1, 2019

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
February 2020 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Feb 1, 2020

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
August 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Aug 1, 2020

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Aug 1, 2019

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
November 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Nov 1, 2020

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines May 1, 2020

Medical Policy and Clinical UM Guidelines notification letter (MAC)

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Jan 1, 2021

Medical Policy, Clinical UM Guidelines, and Pre-certification changes notification letter

August 2018 Anthem Important Updates - NV Medical Policy & Clinical Guidelines Aug 17, 2018

Medical Policy, Clinical UM Guidelines, and Pre-certification changes notification letter

November 2018 Anthem Important Updates - NV Medical Policy & Clinical Guidelines Nov 1, 2018

Medical Policy, Clinical UM Guidelines, and Pre-certification changes notification letter

September 2018 Anthem Important Updates - NV Medical Policy & Clinical Guidelines Aug 31, 2018

Medical Record Standards

August 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Aug 1, 2020

Modifier 63 reminder: Professional

July 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Jul 1, 2019

Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period - Professional

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

Modifier 79 reminder: Professional

July 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Jul 1, 2019

Modifier Rules (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jan 1, 2021

Modifier Rules (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
November 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Nov 1, 2020

Multiple Diagnostic Imaging Procedures (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jan 1, 2021

New clinical guideline: Home Parenteral Nutrition, effective November 1, 2021

Material adverse change (MAC)
August 2021 Anthem Provider News - Nevada Medical Policy & Clinical Guidelines Aug 1, 2021

New Clinical Guideline: Pneumatic Compression Devices, effective December 1, 2019 (MAC)

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Nevada Medical Policy & Clinical Guidelines Sep 1, 2019

New MCG 24th Edition Guidelines

July 2020 Anthem Provider News and Important Updates -- Nevada Medical Policy & Clinical Guidelines Jul 1, 2020

New Reimbursement Policies (Professional): Durable Medical Equipment - Rent to Purchase and Durable Medical Equipment - Modifiers

December 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Dec 1, 2019

New reimbursement policy update: Inpatient Facility Transfers (Facility) (MAC)

Material adverse change (MAC)
September 2021 Anthem Provider News - Nevada Reimbursement Policies Sep 1, 2021

New reimbursement policy: Multiple and Bilateral Surgery Processing (facility) (MAC)

Material adverse change (MAC)

October 2021 Anthem Provider News - Nevada Reimbursement Policies Oct 1, 2021

New reimbursement policy: Non-Patient Laboratory Services (facility)

Material adverse change (MAC)
July 2021 Anthem Provider News - Nevada Reimbursement Policies Jul 1, 2021

Newborn Inpatient Stays (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Apr 1, 2021
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