Indiana
Provider Communications

January 2023 Anthem Provider News - Indiana

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Title Category

Professional system updates for 2023

Administrative

Remittance advice message enhancements: Providing clear descriptions and actionable next steps

Administrative

Notification regarding reimbursement changes to COVID-19 laboratory services codes

Administrative

Outpatient system updates for 2023

Administrative

Childhood Immunization Status and Lead Screening in Children for HEDIS

Administrative

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT code list update*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Updates to AIM Specialty Health Musculoskeletal - Interventional Pain Management Clinical Appropriateness Guidelines*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines - Material adverse change*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Updates to AIM Specialty Health Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines*

*Change to Prior Authorization Requirements
Medical Policy & Clinical Guidelines

Outpatient facility revenue code billing requirements

Reimbursement Policies

Specialty pharmacy updates - January 2023*

*Change to Prior Authorization Requirements
Pharmacy

Guidance for coding evaluation and management services for new and established patients

Medicaid

Attention physicians and lab providers: COVID-19 update regarding reimbursement

Medicaid

Keep up with Medicaid News - January 2023

- This is Quitting: Helping teens and young adults quit vaping
- Prior Authorization Updates for Medications Billed Under the Medical Benefit (Vabysmo)
Medicaid

Cleveland-Cliffs offers Medicare Advantage option

Medicare

Keep up with Medicare news - January 2023

- Prior authorization requirement changes
- New specialty pharmacy medical step therapy requirements (Inflectra & Renflexis)
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Cimerli)
- Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines
Medicare

Federal Employee Program observation conversion for musculoskeletal cases*

*Change to Prior Authorization Requirements
Federal Employee Plan (FEP)
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