Postponed - review of professional claims with emergency room level 5 E/M codes
In a communication dated June 1, 2019, we advised you that we were initiating post-payment reviews for professional emergency room (ER) claims billed with level 5 ER evaluation and management (E/M) codes 99285 and G0384. The implementation of this policy has been postponed.
Note that this update relates only to the policy announced on June 1, 2019. All other current policies applicable to you, including but not limited to other audit or reimbursement policies pertaining to ER claims, are unaffected by this update. We will keep you informed about the initiation of the review process; however, we require proper coding and billing to help ensure prompt and accurate payment.
January 2020 Anthem Maine Provider News