Missouri
Provider Communications

Articles Category: Policy Updates

Title Publication Category Date

Reimbursement policy update: Modifier Rules - Professional

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

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

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

Reimbursement policy update: Modifier 66: Surgical Teams - Professional

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

Medical policy and clinical guideline updates – September 2022

September 2022 Anthem Provider News - Missouri Medical Policy & Clinical Guidelines Sep 1, 2022

New reimbursement policy: Transitional Care Management - professional

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

New reimbursement policy: Modifier FB - Professional and Facility

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

Reimbursement policy update: Modifier Rules - Professional

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

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

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

Retraction for reimbursement policy: Sexually Transmitted Infections - Professional

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

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

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

Medical policy and clinical guideline updates - June 2022

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

Updates to AIM musculoskeletal clinical appropriateness guidelines

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

Updates to AIM advanced imaging clinical appropriateness guidelines

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

Updates to AIM sleep disorder management clinical appropriateness guidelines

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

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

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

MCG Care Guidelines 26th Edition

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

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

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

Medical policy and clinical guideline updates - February 2022

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

Update: Continuation of skilled nursing facility (SNF) program in Missouri

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

Reimbursement policy update: Multiple diagnostic imaging facility

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

RETRACTION: Inpatient Facility Transfers - facility reimbursement policy

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

Medical policy and clinical guideline updates - December 2021

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

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

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

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

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

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

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

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline

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

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

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

Reimbursement policy update: Virtual Visits - Professional and Facility

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

Continuation of skilled nursing facility (SNF) program in Missouri

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

New reimbursement policy: Multiple and Bilateral Surgery Processing - Facility

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

Reimbursement policy clarification: Claims requiring additional documentation - Facility

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

Medical policy and clinical guideline updates - October 2021

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

Reimbursement policy update: Sexually transmitted infections testing - Professional

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

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

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

Reimbursement policy update: Drug Screen Testing - Professional

September 2021 Anthem Provider News - Missouri Reimbursement Policies Sep 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 - Missouri Medical Policy & Clinical Guidelines Aug 1, 2021

Reimbursement policy update: Virtual Visits (Professional and Facility)

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

Reimbursement policy update: Claims requiring additional documentation (Facility)

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

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

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

Medical Policy and Clinical Guideline Updates - July 2021

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

New reimbursement policy: Non-patient laboratory services - Facility

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

Reimbursement policy update: Consultations - Professional

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

Medical policy and clinical guideline updates - June 2021

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

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

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

Updates to AIM advanced imaging clinical appropriateness guidelines

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

Updates to AIM musculoskeletal program clinical appropriateness guidelines

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

Reimbursement policy update: Outpatient facility claim edits

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

New prior authorization requirement: Kidney transplantation

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

Update to AIM Specialty Health oncologic imaging clinical appropriateness guidelines

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

Reimbursement policy update: Claims Requiring Additional Documentation - Facility

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

Reimbursement policy reminder: Readmission - Facility

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

Reimbursement policy update: Frequency editing - Professional

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

Medical policy and clinical guideline updates - April 2021

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

Update: Clinical guideline adoption postponed

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

MCG Care Guidelines 25th Edition available

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

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

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

New reimbursement policy: Newborn Inpatient Stays for facilities

April 2021 Anthem Provider News - Missouri Reimbursement Policies Apr 1, 2021

Maximizing efficient, high quality COVID-19 screenings

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

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

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

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

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

Medical Policy and Clinical Guideline Updates - February 2021

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

Reimbursement policy update: Emergency Room Transfers - Facility

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

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

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

Medical Policy and Clinical Guideline Updates - January 2021

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

MCG Care Guidelines 24th Edition Customization

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

Reimbursement policy update: Multiple diagnostic imaging procedures - Professional

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

Reimbursement policy update: Frequency editing - Professional

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

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

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

Reimbursement policy update: Modifier Rules - Professional

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

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

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

Medical policy and clinical guideline updates - December 2020

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

Updates to AIM Cardiology clinical appropriateness guidelines

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

Updates to AIM Advanced Imaging clinical appropriateness guideline

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

Updates to AIM Radiation Oncology clinical appropriateness guideline

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

Reimbursement policy update: Bundled services and supplies (Professional)

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

Anthem expands hospice policy

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

Transition to AIM Rehabilitative Services clinical appropriateness guidelines

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

Clinical practice and preventive health guidelines available on anthem.com

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

Medical policy and clinical guideline updates - November 2020

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

Correction to Prior Authorization Update for Commercial business

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

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

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

Reimbursement policy update: Bundled services and supplies (Professional)

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

Reminder: Post-service reviews using AIM

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

Reimbursement policy update: Modifier rules (Professional)

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

Transition to AIM rehabilitative service clinical appropriateness guidelines

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

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

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

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

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

Medical policy and clinical guideline updates - October 2020

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

Prior authorization update for Commercial Individual Business

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

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

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

Reimbursement policy update: Laboratory and venipuncture (Professional)

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

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

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

Reimbursement policy update: Frequency Editing (Professional)

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