Wisconsin
Provider Communications

Articles

Title Publication Category Date

Updated COVID-19 Medicare and Medicaid Information

For the latest COVID-19 Medicare and Medicaid information, please check Medicare Advantage Provider News Archives and Medicaid Provider News – COVID-19.
COVID-19 Information - Wisconsin State & Federal Mar 25, 2020

RETRACTION: Inpatient Facility Transfers - facility reimbursement policy

December 2021 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2021

Reimbursement policy update: Bundled services and supplies (Professional)*

December 2020 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2020

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - Professional*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2021

Reimbursement policy update: DRG newborn inpatient stays (Facility)*

December 2020 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2020

New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams - Professional*

*Material Adverse Change (MAC)
December 2021 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2021

Reimbursement policy update: Virtual Visits - Professional and Facility

December 2021 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2021

Clinical Validation: Professional*

July 2019 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2019

New Reimbursement Policies: Maternity Services and Multiple Delivery - Professional*

September 2019 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2019

Modifier 79 reminder: Professional

July 2019 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2019

Modifier 63 reminder: Professional

July 2019 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2019

ICD-10-CM Coding Guidelines and Laterality: Professional

July 2019 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2019

New Reimbursement Policy: Intensity Modulated Radiation Therapy Planning and Delivery - Professional*

September 2019 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2019

Claim editing update for Excludes1 notes

September 2019 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2019

Reimbursement Policy Update: Bundled Services-Professional*

August 2019 Anthem Provider News - Wisconsin Reimbursement Policies Aug 1, 2019

Reimbursement Policy Update: Frequency Editing-Professional*

August 2019 Anthem Provider News - Wisconsin Reimbursement Policies Aug 1, 2019

New reimbursement policy: Transitional Care Management - professional

July 2022 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Multiple diagnostic imaging procedures - Professional*

January 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2021

New reimbursement policy: Modifier FB - Professional and Facility*

*Material Adverse Change (MAC)
July 2022 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2022

Outpatient Facility Edit Implementation*

January 2020 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2020

Reimbursement policy update: Frequency editing - Professional*

January 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Guidelines for reporting timed units for physical medicine and rehabilitation - Professional*

January 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Modifier Rules - Professional*

January 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Modifier Rules - Professional*

*Material Adverse Change (MAC)
July 2022 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2022

Integrated Medical and Behavioral Healthcare Services Billing

October 2018 Anthem Wisconsin Provider Newsletter Reimbursement Policies Sep 28, 2018

Tips for billing CPT modifier 33

October 2018 Anthem Wisconsin Provider Newsletter Reimbursement Policies Sep 28, 2018

Reimbursement policy update: Unit frequency maximum for drugs and biologicals - Professional*

January 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Laboratory and venipuncture services - professional and facility*

*Material Adverse Change (MAC)
July 2022 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2022

New reimbursement policy: Place of Service - Facility*

*Material Adverse Change (MAC)
July 2022 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2022

New Reimbursement Policy - Facility Revenue Code Billing

October 2018 Anthem Wisconsin Provider Newsletter Reimbursement Policies Sep 28, 2018

Reimbursement policy clarification: Claims requiring additional documentation - Facility

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

Reimbursement Policy Update - Readmissions (Facility)

October 2018 Anthem Wisconsin Provider Newsletter Reimbursement Policies Sep 28, 2018

View reimbursement policies online at anthem.com

October 2018 Anthem Wisconsin Provider Newsletter Reimbursement Policies Sep 28, 2018

Retraction for reimbursement policy: Sexually Transmitted Infections - Professional

July 2022 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Distinct Procedural Service, Modifiers 59, XE, XP, XS, XU - professional*

*Material Adverse Change (MAC)
July 2022 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2022

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

March 2021 Anthem Provider News - Wisconsin Reimbursement Policies Mar 1, 2021

Reimbursement Policy Update: Claims requiring additional documentation (Facility)*

May 2020 Anthem Provider News - Wisconsin Reimbursement Policies May 1, 2020

New Reimbursement Policies: Nurse Practitioner and Physician Assistant Services (Professional)*

June 2020 Anthem Provider News - Wisconsin Reimbursement Policies Jun 1, 2020

Reminder about system updates

May 2020 Anthem Provider News - Wisconsin Reimbursement Policies May 1, 2020

Update regarding E/M with modifier 25 - Professional*

February 2019 Anthem Wisconsin Provider Newsletter Reimbursement Policies Feb 1, 2019

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

December 2019 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2019

System updates for 2020 (Professional)

December 2019 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2019

Reimbursement policy update: Emergency department - leveling of Evaluation and Management services (Facility)*

October 2020 Anthem Provider News - Wisconsin Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Laboratory and venipuncture (Professional)*

October 2020 Anthem Provider News - Wisconsin Reimbursement Policies Oct 1, 2020

Update to evaluation and management services correct coding - Professional

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

Reimbursement policy update: Claims requiring additional documentation policy (Facility)

October 2020 Anthem Provider News - Wisconsin Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Outpatient facility claim edits

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

Reimbursement Policy Updates: February 2019*

February 2019 Anthem Wisconsin Provider Newsletter Reimbursement Policies Feb 1, 2019

Reimbursement Policy Update: Injectable Substances with Related Injection Services - Professional*

February 2019 Anthem Wisconsin Provider Newsletter Reimbursement Policies Feb 1, 2019

New Reimbursement Policy: Ambulance Transportation -- Professional*

June 2019 Anthem Provider Newsletter - Wisconsin Reimbursement Policies Jun 1, 2019

Reimbursement Policy Update: Frequency Editing -- Professional*

June 2019 Anthem Provider Newsletter - Wisconsin Reimbursement Policies Jun 1, 2019

Reimbursement policy reminder: Readmission - Facility

May 2021 Anthem Provider News - Wisconsin Reimbursement Policies May 1, 2021

Reimbursement policy update: Frequency editing - Professional

May 2021 Anthem Provider News - Wisconsin Reimbursement Policies May 1, 2021

Reimbursement policy update: Sexually transmitted infections testing - Professional*

*Material Adverse Change (MAC)
September 2021 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2021

New reimbursement policy update: Inpatient Facility Transfers - Facility* - RETRACTION

*Material Adverse Change (MAC)
September 2021 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2021

Reimbursement policy update: Consultations - Professional*

*Material Adverse Change (MAC)
July 2021 Anthem Provider News - Wisconsin Reimbursement Policies Jul 1, 2021

Update: Drug Screen Testing - Professional*

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

Reimbursement policy update: Drug Screen Testing - Professional*

*Material Adverse Change (MAC)
September 2021 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2021

Reminder: HCPCS code A0998 Ambulance response and treatment with no transport is active and available for use

January 2019 Anthem Wisconsin Provider Newsletter Reimbursement Policies Jan 1, 2019

Reimbursement policy update: Virtual Visits (Professional and Facility)*

*Material Adverse Change (MAC)
August 2021 Anthem Provider News - Wisconsin Reimbursement Policies Aug 1, 2021

Reimbursement policy update: Claims requiring additional documentation (Facility)*

*Material Adverse Change (MAC)
August 2021 Anthem Provider News - Wisconsin Reimbursement Policies Aug 1, 2021

Reimbursement policy update: Distinct Procedural Service, Modifiers 59 and XE, XP, XS, & XU*

*Material Adverse Change (MAC)
August 2021 Anthem Provider News - Wisconsin Reimbursement Policies Aug 1, 2021

New reimbursement policy: Documentation standards for episodes of care (Professional)*

November 2020 Anthem Provider News - Wisconsin Reimbursement Policies Nov 1, 2020

Reimbursement policy update: Modifier rules (Professional)*

November 2020 Anthem Provider News - Wisconsin Reimbursement Policies Nov 1, 2020

Reimbursement policy update: Bundled services and supplies (Professional)*

November 2020 Anthem Provider News - Wisconsin Reimbursement Policies Nov 1, 2020

Bundled Services and Supplies (Professional)

December 2018 Anthem Wisconsin Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement policy update: Distinct Procedural Services- Modifiers 59, XE, XP, XS, XU (Professional)*

September 2020 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2020

Reimbursement for Convenience Surgical Supply Kits: Professional

December 2018 Anthem Wisconsin Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement policy update: Frequency Editing (Professional)*

September 2020 Anthem Provider News - Wisconsin Reimbursement Policies Sep 1, 2020

View reimbursement policies online at anthem.com

December 2018 Anthem Wisconsin Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement Policy Updates - December 2018

December 2018 Anthem Wisconsin Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement Policy Update - Scope of License (Professional)

December 2018 Anthem Wisconsin Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement policy update: Emergency Room Transfers - Facility*

February 2021 Anthem Provider News - Wisconsin Reimbursement Policies Feb 1, 2021

Reimbursement policy update: Claims Requiring Additional Documentation - Facility*

*Material Adverse Change (MAC)
May 2021 Anthem Provider News - Wisconsin Reimbursement Policies May 1, 2021

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

February 2021 Anthem Provider News - Wisconsin Reimbursement Policies Feb 1, 2021

Clarification to reimbursement policy updates: Modifier Rules and Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation - professional

November 2021 Anthem Provider News - Wisconsin Reimbursement Policies Nov 1, 2021

Reimbursement Policy update: Place of Service-Professional*

October 2019 Anthem Provider News - Wisconsin Reimbursement Policies Oct 1, 2019

Reimbursement Policy Update - Claims requiring additional documentation (Facility)

September 2018 Anthem Wisconsin eUpdate Reimbursement Policies Aug 30, 2018

New Reimbursement Policy: Partial Hospitalization Program and Intensive Outpatient Program Services Facility*

April 2019 Anthem Provider Newsletter - Wisconsin Reimbursement Policies Apr 1, 2019

Reimbursement policy update: Multiple diagnostic imaging facility*

*Material Adverse Change (MAC)
January 2022 Anthem Provider News - Wisconsin Reimbursement Policies Jan 1, 2022

Reimbursement Policy Update: Claims requiring additional documentation (Facility)*

August 2020 Anthem Provider News - Wisconsin Reimbursement Policies Aug 1, 2020

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

*Material Adverse Change (MAC)
June 2022 Anthem Provider News - Wisconsin Reimbursement Policies Jun 1, 2022

Let’s vaccinate

June 2021 Anthem Provider News - Wisconsin Products & Programs Jun 1, 2021

UPDATE: New Level of Care Medical Necessity Review of Upper and Lower Endoscopy procedures is delayed

June 2020 Anthem Provider News - Wisconsin Products & Programs Jun 1, 2020

Update: New go-live date for level of care medical necessity review of upper and lower endoscopy procedures

July 2020 Anthem Provider News - Wisconsin Products & Programs Jul 1, 2020

Update to AIM Specialty Health clinical appropriateness guidelines

October 2018 Anthem Wisconsin Provider Newsletter Products & Programs Sep 28, 2018

Update to AIM Specialty Health radiation oncology clinical appropriateness guidelines

October 2018 Anthem Wisconsin Provider Newsletter Products & Programs Sep 28, 2018

Update to AIM Specialty Health sleep disorder management clinical appropriateness guidelines

October 2018 Anthem Wisconsin Provider Newsletter Products & Programs Sep 28, 2018

Anthem fights opioid addiction: Extension for Community Healthcare Outcomes and Quality Medication-Assisted Therapy

October 2018 Anthem Wisconsin Provider Newsletter Products & Programs Sep 28, 2018

Health Care Reform (including Health Insurance Exchange) Updates and Notifications

October 2018 Anthem Wisconsin Provider Newsletter Products & Programs Sep 28, 2018

Enhanced reimbursement for voluntary Cancer Care Quality program to be discontinued effective December 31, 2022

July 2022 Anthem Provider News - Wisconsin Products & Programs Jul 1, 2022

New BlueHPN network plans available for employee open enrollment Fall 2021

October 2021 Anthem Provider News - Wisconsin Products & Programs Oct 1, 2021

New Musculoskeletal and Pain Management Solution Effective for Select National ASO Accounts January 1, 2020

January 2020 Anthem Provider News - Wisconsin Products & Programs Jan 1, 2020

New Blue HPN® network included in plans available for employee open enrollment Fall 2020

October 2020 Anthem Provider News - Wisconsin Products & Programs Oct 1, 2020

Reminder and update: new Rehabilitative Program effective July 1, 2019

June 2019 Anthem Provider Newsletter - Wisconsin Products & Programs Jun 1, 2019

Reminder: New AIM Rehabilitative Program effective November 1, 2019

December 2019 Anthem Provider News - Wisconsin Products & Programs Dec 1, 2019

REMINDER: new AIM Rehabilitative Program effective November 1, 2019

November 2019 Anthem Provider News - Wisconsin Products & Programs Nov 1, 2019

Level of Care medical necessity reviews for upper and lower endoscopy procedures begin June 1, 2020*

March 2020 Anthem Provider News - Wisconsin Products & Programs Mar 1, 2020

Site of care medical necessity reviews expands to numerous surgical procedures beginning December 1, 2020*

September 2020 Anthem Provider News - Wisconsin Products & Programs Sep 1, 2020

Meet your Cancer Care Navigator

Anthem’s new cancer support program helps improve outcomes while easing burdens for you and your patients.
September 2020 Anthem Provider News - Wisconsin Products & Programs Sep 1, 2020
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