Kentucky
Provider Communications

Articles Category: Policy Updates

Title Publication Category Date

New reimbursement policy: Transitional Care Management - professional

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

New reimbursement policy: Modifier FB - Professional and Facility

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

Reimbursement policy update: Modifier Rules - Professional

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

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

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

New reimbursement policy: Place of Service - Facility

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

Retraction for reimbursement policy: Sexually Transmitted Infections - Professional

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

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

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

Medical policy and clinical guideline updates - June 2022

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

Updated guidance on prior authorization requirements for admissions to in-network long-term acute care hospitals (LTACHs)

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

Updates to AIM musculoskeletal clinical appropriateness guidelines

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

Updates to AIM advanced imaging clinical appropriateness guidelines

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

Updates to AIM sleep disorder management clinical appropriateness guidelines

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

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

June 2022 Anthem Provider News - Kentucky Reimbursement Policies Jun 1, 2022

MCG Care Guidelines 26th Edition

May 2022 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines May 1, 2022

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

March 2022 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Mar 1, 2022

New reimbursement policy: Multiple and Bilateral Surgery Processing - Facility

March 2022 Anthem Provider News - Kentucky Reimbursement Policies Mar 1, 2022

Medical policy and clinical guideline updates - February 2022

February 2022 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Feb 1, 2022

Reimbursement policy update: Multiple diagnostic imaging facility

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

Medical policy and clinical guideline updates - December 2021

December 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Dec 1, 2021

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

December 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

December 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

December 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline

December 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Dec 1, 2021

RETRACTION: Inpatient Facility Transfers - facility reimbursement policy

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

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

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

Reimbursement policy update: Virtual Visits - Professional and Facility

December 2021 Anthem Provider News - Kentucky 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 - Kentucky Reimbursement Policies Nov 1, 2021

Medical policy and clinical guideline updates - October 2021

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

Reimbursement policy clarification: Claims requiring additional documentation - Facility

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

Clarification to reimbursement policy update: Virtual Visits - Professional and Facility

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

Updated guidance on prior authorization requirements for admissions to in-network skilled nursing facilities

September 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Sep 1, 2021

Reimbursement policy update: Sexually transmitted infections testing - Professional

September 2021 Anthem Provider News - Kentucky Reimbursement Policies Sep 1, 2021

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

September 2021 Anthem Provider News - Kentucky Reimbursement Policies Sep 1, 2021

Reimbursement policy update: Drug Screen Testing - Professional

September 2021 Anthem Provider News - Kentucky Reimbursement Policies Sep 1, 2021

Updated guidance on prior authorization requirements for admissions to in-network skilled nursing facilities

Updated guidance for admissions to in-network SNFs - Kentucky Medical Policy & Clinical Guidelines Aug 4, 2021

Update: AIM Musculoskeletal Program effective November 1, 2021 - Site of care reviews

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

Reimbursement policy update: Virtual Visits (Professional and Facility)

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

Reimbursement policy update: Claims requiring additional documentation (Facility)

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

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

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

Medical Policy and Clinical Guideline Updates - July 2021

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

Reminder: Updated AIM rehabilitative program effective August 1, 2021 - Site of service reviews

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

New reimbursement policy: Non-patient laboratory services - Facility

July 2021 Anthem Provider News - Kentucky Reimbursement Policies Jul 1, 2021

Reimbursement policy update: Consultations - Professional

July 2021 Anthem Provider News - Kentucky Reimbursement Policies Jul 1, 2021

Medical policy and clinical guideline updates - June 2021

June 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jun 1, 2021

Prior authorization for genetic testing medical policy effective September 1, 2021

June 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jun 1, 2021

Updates to AIM advanced imaging clinical appropriateness guidelines

June 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jun 1, 2021

Updates to AIM musculoskeletal program clinical appropriateness guidelines

June 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jun 1, 2021

New Back Pain Management Program effective July 19, 2021

June 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Jun 1, 2021

Reimbursement policy update: Outpatient facility claim edits

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

New prior authorization requirement: Kidney transplantation

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

Update to AIM Specialty Health oncologic imaging clinical appropriateness guidelines

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

Updated AIM rehabilitative program effective August 1, 2021 - Initial evaluations and site of service reviews

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

Modification to voluntary Cancer Care Quality Program (CCQP) enhanced reimbursement to begin July 1, 2021

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

Reimbursement policy update: Claims Requiring Additional Documentation - Facility

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

Reimbursement policy reminder: Readmission - Facility

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

Reimbursement policy update: Frequency editing - Professional

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

Medical policy and clinical guideline updates - April 2021

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

Update: Clinical guideline adoption postponed

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

MCG Care Guidelines 25th Edition available

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

Update for Commercial providers: AIM sleep program CPT code E1399, NOC: Durable medical equipment, miscellaneous

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

Maximizing efficient, high quality COVID-19 screenings

COVID-19 Information - Kentucky Medical Policy & Clinical Guidelines Apr 1, 2021

Update: Notice of changes to the AIM Small Joint Surgery guideline

March 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Mar 1, 2021

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

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

Medical Policy and Clinical Guideline Updates - February 2021

February 2021 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Feb 1, 2021

Reimbursement policy update: Emergency Room Transfers - Facility

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

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

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

Medical Policy and Clinical Guideline Updates - January 2021

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

MCG Care Guidelines 24th Edition Customization

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

Reimbursement policy update: Multiple diagnostic imaging procedures - Professional

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

Reimbursement policy update: Frequency editing - Professional

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

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

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

Reimbursement policy update: Modifier Rules - Professional

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

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

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

Medical policy and clinical guideline updates - December 2020

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

Updates to AIM Cardiology clinical appropriateness guidelines

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

Updates to AIM Advanced Imaging clinical appropriateness guideline

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

Updates to AIM Radiation Oncology clinical appropriateness guideline

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

Reimbursement policy update: Bundled services and supplies (Professional)

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

Reimbursement policy update: DRG newborn inpatient stays (Facility)

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

Anthem expands hospice policy

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

Transition to AIM Rehabilitative Services clinical appropriateness guidelines

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

Clinical practice and preventive health guidelines available on anthem.com

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

Medical policy and clinical guideline updates - November 2020

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

Correction to Prior Authorization Update for Commercial business

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

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

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

Reimbursement policy update: Bundled services and supplies (Professional)

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

Reminder: Post-service reviews using AIM

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

Reimbursement policy update: Modifier rules (Professional)

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

Transition to AIM rehabilitative service clinical appropriateness guidelines

October 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Oct 1, 2020

Reminder: Expansion of AIM Musculoskeletal Program effective November 1, 2020

October 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Oct 1, 2020

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

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

Medical policy and clinical guideline updates - October 2020

October 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Oct 1, 2020

Prior authorization update for Commercial Individual Business

October 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Oct 1, 2020

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

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

Reimbursement policy update: Laboratory and venipuncture (Professional)

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

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

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

Reimbursement policy update: Frequency Editing (Professional)

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

Medical policy and clinical guideline updates - August 2020

August 2020 Anthem Provider News - Kentucky Medical Policy & Clinical Guidelines Aug 1, 2020
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