CommercialMedicare AdvantageAugust 1, 2024
August 2024 Provider Newsletter
Administrative
Medicare AdvantageAugust 1, 2024
ICD-10-CM Excludes1 notesCommercialAugust 1, 2024
CAA: Providers required to verify their online provider directory informationCommercialAugust 1, 2024
Incidental services — facility editing updateCommercialAugust 1, 2024
Device-dependent procedures — facility editing updateCommercialJuly 24, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageJuly 16, 2024
Expansion of Carelon Medical Benefits Management, Inc. programsMedicare AdvantageJuly 9, 2024
Coming soon — digital-only authorization case status notifications for MedicareEducation & Training
CommercialMedicare AdvantageAugust 1, 2024
Coming soon: Provider e-Learning Resource Center for Payment IntegrityCommercialMedicare AdvantageAugust 1, 2024
August is National Breastfeeding MonthPolicy Updates
CommercialAugust 1, 2024
Material adverse change
Updates to Carelon Medical Benefits Management Clinical Appropriateness GuidelinesMedicare AdvantageJuly 11, 2024
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness GuidelinesEffective for dates of service on and after November 17, 2024
CommercialAugust 1, 2024
MCG Care Guidelines 28th editionMedicare AdvantageJuly 5, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective August 8, 2024
CommercialAugust 1, 2024
Reimbursement policy update: Modifiers 26 and TC — ProfessionalCommercialAugust 1, 2024
Material adverse change
New reimbursement policy: Intraoperative Neuromonitoring — ProfessionalMedicare AdvantageAugust 1, 2024
Reimbursement policy update: Modifier 78CommercialAugust 1, 2024
Material adverse change
Reimbursement policy update: Professional Anesthesia ServiceCommercialAugust 1, 2024
Material adverse change
Reimbursement policy update: Incident to Services — ProfessionalMedicare AdvantageAugust 1, 2024
Reimbursement policy update: Nurse Practitioner and Physician Assistant ServicesCommercialAugust 1, 2024
Material adverse change
Reimbursement policy update: Outpatient Facility Revenue Code Billing Requirements — FacilityProducts & Programs
CommercialAugust 1, 2024
Material adverse change
Correction: Prior authorization updates for specialty pharmacyCOBCBS-CRCM-063083-24
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