CommercialAugust 1, 2024
New reimbursement policy: Intraoperative Neuromonitoring — Professional
Beginning with dates of service on or after November 1, 2024, Anthem will implement a new reimbursement policy titled Intraoperative Neuromonitoring — Professional based on guidelines from the American Academy of Neurology. This reimbursement policy will allow reimbursement for intraoperative neuromonitoring (IONM) when billed by a professional provider with a place of service 19, 21, 22, or 24.
When reporting IONM, providers are required to bill on a CMS-1500 form and use the appropriate place of service. Services must be performed in a hospital setting using the place of service where the member is located even if the monitoring physician is in an office. The following place of service codes are appropriate for use by the monitoring physician:
- Off campus-outpatient hospital (19)
- Inpatient hospital (21)
- On campus-outpatient hospital (22)
- Ambulatory surgical center (24)
For specific policy details, visit reimbursement policy page at anthem.com.
In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
MULTI-BCBS-CM-062863-24-SRS62734
PUBLICATIONS: August 2024 Provider Newsletter
To view this article online:
Or scan this QR code with your phone