Georgia
Provider Communications

Articles Category: Policy Updates

Title Publication Category Date

Reimbursement policy update: Bundled Services and Supplies - Professional (MAC)

Material adverse change (MAC)
December 2022 Anthem Provider News - Georgia Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility (MAC)

Material adverse change (MAC)

December 2022 Anthem Provider News - Georgia Reimbursement Policies Dec 1, 2022

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update

December 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Dec 1, 2022

Reimbursement policy update: Multiple Surgery - Facility

December 2022 Anthem Provider News - Georgia Reimbursement Policies Dec 1, 2022

AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update (MAC)

Material adverse change (MAC)
December 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Dec 1, 2022

Correction to reimbursement policy: Place of Service (Facility)(MAC)

Material adverse change (MAC)
November 2022 Anthem Provider News - Georgia Reimbursement Policies Nov 1, 2022

Improve patient outcomes for colorectal cancer screening with Labcorp’s FIT test

November 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Nov 1, 2022

Transition to AIM Specialty Health Perirectal Hydrogel Spacer for Prostate Radiotherapy Clinical Appropriateness Guideline

This communication applies to the Commercial and Medicare Advantage programs from Anthem Blue Cross and Blue Shield (Anthem) in Georgia.
November 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Nov 1, 2022

Monkeypox and smallpox vaccines: Product code on claims

October 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Oct 1, 2022

Georgia Medical Policy and Clinical Guideline updates October 1, 2022

October 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Oct 1, 2022

Reimbursement policy update: Multiple and Bilateral Surgery Processing (Professional)

October 2022 Anthem Provider News - Georgia Reimbursement Policies Oct 1, 2022

Reimbursement policy update: Three-Dimensional (3D) Radiology Services (Professional & Facility)

October 2022 Anthem Provider News - Georgia Reimbursement Policies Oct 1, 2022

Commercial reimbursement policy update to Modifier 66: Surgical Teams (Professional)

September 2022 Anthem Provider News - Georgia Reimbursement Policies Sep 1, 2022

Policy Update: Modifier Rules (Professional) (MAC)

Material adverse change (MAC)
September 2022 Anthem Provider News - Georgia Reimbursement Policies Sep 1, 2022

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

September 2022 Anthem Provider News - Georgia Reimbursement Policies Sep 1, 2022

CORRECTION: Georgia Medical Policy and Clinical Guideline updates July 1, 2022

CORRECTION: Georgia Medical Policy and Clinical Guideline updates July 1, 2022 Medical Policy & Clinical Guidelines Aug 4, 2022

Georgia Medical Policy and Clinical Guideline updates July 1, 2022

August 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Aug 1, 2022

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

July 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Jul 1, 2022

Help patients heal from the comfort of home with Hospital in Home care

July 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Jul 1, 2022

Reimbursement policy update: Place of Service (Facility)(MAC)

Material adverse change (MAC)
July 2022 Anthem Provider News - Georgia Reimbursement Policies Jul 1, 2022

New reimbursement policy: Transitional Care Management (Professional)

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

Reimbursement policy update: Distinct Procedural Service, Modifiers 59 and XE, XP, XS, and XU (Professional)(MAC)

Material adverse change (MAC)
July 2022 Anthem Provider News - Georgia Reimbursement Policies Jul 1, 2022

Retraction for reimbursement policy: Sexually Transmitted Infections (Professional)

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

New reimbursement policy: Modifier FB (Professional & Facility)(MAC)

Material adverse change (MAC)
July 2022 Anthem Provider News - Georgia Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Laboratory and Venipuncture Services (Professional & Facility)(MAC)

Material adverse change (MAC)
July 2022 Anthem Provider News - Georgia Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Modifier Rules (Professional)(MAC)

Material adverse change (MAC)
July 2022 Anthem Provider News - Georgia Reimbursement Policies Jul 1, 2022

Updates to AIM Specialty Health musculoskeletal clinical appropriateness guidelines (MAC)

Material adverse change (MAC)
June 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Jun 1, 2022

Updates to AIM Specialty Health advanced imaging clinical appropriateness guidelines (MAC)

Material adverse change (MAC)
June 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Jun 1, 2022

Updates to AIM Specialty Health sleep disorder management clinical appropriateness guidelines (MAC)

Material adverse change (MAC)

June 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Jun 1, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services (Facility) (MAC)

Material adverse change (MAC)
June 2022 Anthem Provider News - Georgia Reimbursement Policies Jun 1, 2022

Georgia medical policy and clinical guideline updates 4/1/2021

April 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Apr 1, 2022

AIM Specialty Health Outpatient Rehabilitative and Habilitative Services clinical appropriateness guidelines updates (MAC)

Material adverse change (MAC)
March 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Mar 1, 2022

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

Material adverse change (MAC)
March 2022 Anthem Provider News - Georgia Reimbursement Policies Mar 1, 2022

Clarification to reimbursement policy update: Virtual Visits (professional and facility)

February 2022 Anthem Provider News - Georgia Reimbursement Policies Feb 1, 2022

Georgia medical policy and clinical guideline updates 10/1/2021

January 2022 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Jan 1, 2022

Reimbursement policy update: Bundled Services and Supplies and Distinct Procedural Service, Modifiers 59 and XE, XP, XS, & XU (Professional) (MAC)

January 2022 Anthem Provider News - Georgia Reimbursement Policies Jan 1, 2022

Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management Clinical Appropriateness Guideline (MAC)

Material adverse change (MAC)
December 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines (MAC)

Material adverse change (MAC)
December 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline (MAC)

Material adverse change (MAC)
December 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline (MAC)

Material adverse change (MAC)
December 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Dec 1, 2021

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

Material adverse change (MAC)
December 2021 Anthem Provider News - Georgia Reimbursement Policies Dec 1, 2021

Reimbursement policy update: Virtual Visits (professional and facility)

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

RETRACTION: Inpatient Facility Transfers reimbursement policy (facility)

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

New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams (professional)

December 2021 Anthem Provider News - Georgia Reimbursement Policies Dec 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 - Georgia Reimbursement Policies Nov 1, 2021

Georgia medical policy and clinical guideline updates 10/1/2021

October 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Oct 1, 2021

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

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

Reimbursement policy clarification: Claims Requiring Additional Documentation (facility)

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

Reimbursement policy update: Sexually Transmitted Infections Testing (Professional) (MAC)

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

Reimbursement policy update: Drug Screen Testing (Professional) (MAC)

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

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

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

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

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

Transition to AIM Specialty Health Imaging of the heart clinical appropriateness guideline for Computed Tomography to Detect Coronary Artery Calcification

August 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Aug 1, 2021

Reimbursement policy update: claims requiring additional documentation (facility)

August 2021 Anthem Provider News - Georgia 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 - Georgia Reimbursement Policies Aug 1, 2021

Reimbursement policy update: Virtual Visits (professional and facility)

Material adverse change (MAC)
August 2021 Anthem Provider News - Georgia Reimbursement Policies Aug 1, 2021

Georgia Anthem preapproval list change notification 7/1/2021

Material adverse change (MAC)
July 2021 Anthem Provider News - Georgia Policy Updates Jul 1, 2021

Medical policy and clinical guideline updates 7/1/2021

July 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Jul 1, 2021

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

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

Reimbursement policy update: Consultations (professional)

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

Updates to AIM advanced imaging clinical appropriateness guideline

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

Updates to AIM musculoskeletal program clinical appropriateness guidelines

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

Anthem to enhance claim edits for outpatient facility claims

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

Update to evaluation and management services correct coding (professional)

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

Georgia Anthem preapproval list change notification 5/1/2021

Material adverse change (MAC)
May 2021 Anthem Provider News - Georgia Policy Updates May 1, 2021

Update to AIM Specialty Health Oncologic Imaging clinical appropriateness guidelines

May 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines May 1, 2021

Clinical guideline update

May 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines May 1, 2021

Reimbursement policy reminder: readmission (facility)

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

Reimbursement policy update: frequency editing (professional)

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

Reimbursement policy update: claims requiring additional documentation (facility)

Material adverse change (MAC)
May 2021 Anthem Provider News - Georgia Reimbursement Policies May 1, 2021

Medical policy and clinical guideline updates 4/1/2021

April 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Apr 1, 2021

MCG care guidelines 25th edition

Material adverse change (MAC)
April 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Apr 1, 2021

Georgia Anthem preapproval list change notification 3/1/2021

Material adverse change (MAC)
April 2021 Anthem Provider News - Georgia Policy Updates Apr 1, 2021

New Reimbursement policy update: Place of Service Evaluation and Management Place of Service (Facility)

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

Reimbursement policy update: Professional Anesthesia Services (Professional)

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

Reimbursement policy update: Emergency Room Transfers (Facility)

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

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services (Facility)

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

Anthem Georgia preapproval list change notification 1/1/2021

January 2021 Anthem Provider News - Georgia Policy Updates Jan 1, 2021

Medical Policy and Clinical Guideline updates 1/1/2021

January 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Jan 1, 2021

Reimbursement policy update: Multiple Diagnostic Imaging Procedures (Professional)

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

Reimbursement policy update: Frequency Editing (Professional)

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

Reimbursement policy update: Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation (Professional)

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

Reimbursement policy update: Modifier Rules (Professional)

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

Reimbursement policy update: Unit Frequency Maximum for Drugs and Biologicals (Professional)

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

Evaluation and Management changes 2021

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

Outpatient system updates for 2021 (Facility)

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

Reimbursement policy update: Clinic Charges (Facility)

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

MCG Care Guidelines 24th Edition customization

January 2021 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Jan 1, 2021

Reimbursement policy update: Bundled Services and Supplies (Professional)

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

Reimbursement policy update: DRG Newborn Inpatient Stays (Facility)

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

Anthem expands hospice policy

December 2020 Anthem Provider News - Georgia Policy Updates Dec 1, 2020

Updates to AIM Cardiology clinical appropriateness guidelines

December 2020 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM Advanced Imaging clinical appropriateness guideline

December 2020 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Dec 1, 2020

Updates to AIM Radiation Oncology clinical appropriateness guideline

December 2020 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Dec 1, 2020

Transition to AIM Rehabilitative Services clinical appropriateness guidelines

December 2020 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Dec 1, 2020

Anthem Georgia preapproval list change notification 11/1/2020

November 2020 Anthem Provider News - Georgia Policy Updates Nov 1, 2020

New reimbursement policy: Documentation Standards for Episodes of Care (Professional)

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

Reimbursement policy update: Modifier Rules (Professional)

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

Reimbursement policy update: Bundled Services and Supplies (Professional)

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

Georgia Medical Policy and Clinical Guideline updates 11/1/2020

November 2020 Anthem Provider News - Georgia Medical Policy & Clinical Guidelines Nov 1, 2020
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