Nevada
Provider Communications

Articles Category: Policy Updates / Reimbursement Policies

Title Publication Category Date

Reimbursement policy update: Emergency Department: Leveling of Evaluation and Management Services (facility)

Material adverse change (MAC)
June 2021 Anthem Provider News - Nevada Reimbursement Policies Jun 1, 2021

Evaluation and management services correct coding (professional)

Material adverse change (MAC)
June 2021 Anthem Provider News - Nevada Reimbursement Policies Jun 1, 2021

Anthem to enhance claim edits for outpatient facility claims

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

Reimbursement policy reminder: Readmission (Facility)

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

Reimbursement policy update: Frequency Editing (Professional)

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

Reimbursement policy update: Claims Requiring Additional Documentation (Facility) (MAC)

Material Adverse Change (MAC)
May 2021 Anthem Provider News - Nevada Reimbursement Policies May 1, 2021

Clinic Charges (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Apr 1, 2021

Newborn Inpatient Stays (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
April 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Apr 1, 2021

Emergency Room Transfers (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
February 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Feb 1, 2021

Treatment Rooms with Office Evaluation and Management Services (Facility Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
February 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Feb 1, 2021

Frequency Editing (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jan 1, 2021

Guidelines for Reporting Timed Units: Physical Medicine and Rehab Services (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jan 1, 2021

Modifier Rules (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jan 1, 2021

Unit Frequency Maximum for Drugs and Biologic Substances (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jan 1, 2021

Multiple Diagnostic Imaging Procedures (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
January 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jan 1, 2021

System updates impacting Professional reimbursement policies for 2021

January 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jan 1, 2021

Outpatient System updates for Facility reimbursement policies 2021

January 2021 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jan 1, 2021

Bundled Services and Supplies (Professional Reimbursement Policy) -- Update

December 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Dec 1, 2020

Documentation Standards for Episodes of Care (Professional Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
November 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Nov 1, 2020

Modifier Rules (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
November 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Nov 1, 2020

Bundled Services and Supplies (Professional Reimbursement Policy) – Update (MAC)

Material Adverse Change (MAC)
November 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Nov 1, 2020

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

November 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Nov 1, 2020

Laboratory and Venipuncture Services (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
October 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Oct 1, 2020

Reimbursement policy update -- Claims Requiring Additional Documentation policy (Facility)

October 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Oct 1, 2020

Distinctive Procedural Services, Modifiers 59, XE, XP, XS, XU (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
September 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Sep 1, 2020

Frequency Editing (Professional Reimbursement Policy) -- Update (MAC)

Material Adverse Change (MAC)
September 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Sep 1, 2020

Reimbursement policy update -- Claims Requiring Additional Documentation (Facility)

August 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Aug 1, 2020

Nurse Practitioner and Physician Assistant Service (Professional Reimbursement Policy) -- New (MAC)

Material Adverse Change (MAC)
June 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies Jun 1, 2020

Reminder about System Updates

May 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies May 1, 2020

Claims requiring additional documentation (Facility Reimbursement Policy -- Update for Inpatient and Outpatient) (MAC)

Material Adverse Change (MAC)
May 2020 Anthem Provider News and Important Updates -- Nevada Reimbursement Policies May 1, 2020

Clinical Laboratory Improvement Amendments (CLIA) claim requirements effective May 1, 2020 (MAC)

Material Adverse Change (MAC)
February 2020 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Feb 1, 2020

Outpatient facility edit implementation effective April 26, 2020 (MAC)

Material Adverse Change (MAC)
January 2020 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Jan 1, 2020

System updates for 2020 (Professional)

December 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Dec 1, 2019

New Reimbursement Policies (Professional): Durable Medical Equipment - Rent to Purchase and Durable Medical Equipment - Modifiers

December 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Dec 1, 2019

Place of Service (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
October 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Oct 1, 2019

Claim editing update for Excludes1 notes

September 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Sep 1, 2019

Maternity Services and Multiple Delivery (Professional Reimbursement Policies – New) (MAC)

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Sep 1, 2019

Intensity Modulated Radiation Therapy Planning and Delivery (Professional Reimbursement Policy – New) (MAC)

Material Adverse Change (MAC)
September 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Sep 1, 2019

Claims requiring additional documentation facility reimbursement policy update

September 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Sep 1, 2019

Bundled Services (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Aug 1, 2019

Frequency Editing (Professional Reimbursement Policy - Update) (MAC)

Material Adverse Change (MAC)
August 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Aug 1, 2019

Modifier 79 reminder: Professional

July 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Jul 1, 2019

Modifier 63 reminder: Professional

July 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Jul 1, 2019

ICD-10-CM Coding Guidelines and Laterality: Professional

July 2019 Anthem Provider News and Important Updates - Nevada Reimbursement Policies Jul 1, 2019

Ambulance Transportation (Professional Reimbursement Policy - New)

June 2019 Anthem Important Updates - Nevada Reimbursement Policies Jun 1, 2019

Clinical Validation (Professional Reimbursement Policy - Update)

June 2019 Anthem Important Updates - Nevada Reimbursement Policies Jun 1, 2019

Frequency Editing (Professional Reimbursement Policy - Update)

June 2019 Anthem Important Updates - Nevada Reimbursement Policies Jun 1, 2019

CORRECTION: Notice regarding post-pay review of ER claims

CORRECTION: Notice regarding post-pay review of ER claims - Nevada Reimbursement Policies May 16, 2019

Review of professional claims with emergency room level 5 E/M codes - *CORRECTION: For more information, refer to article published May 16, 2019.

May 2019 Anthem Provider Newsletter - Nevada Reimbursement Policies May 1, 2019

Drug Screen Testing (Professional Reimbursement Policy - Updated)

May 2019 Anthem Provider Newsletter - Nevada Reimbursement Policies May 1, 2019

Partial Hospitalization and Intensive Outpatient Program Services (Facility Reimbursement Policy - New)

April 2019 Anthem Important Updates - Nevada Reimbursement Policies Apr 1, 2019

Body Mass Index (BMI) (Facility Reimbursement Policy - Update)

February 2019 Anthem Important Updates - NV Reimbursement Policies Feb 1, 2019

Professional Reimbursement Policy Change and supporting claims editing notification for CMS-1500 submitters

February 2019 Anthem Important Updates - NV Reimbursement Policies Feb 1, 2019

Significant Edits (Professional)

February 2019 Anthem Provider Newsletter - NV Reimbursement Policies Feb 1, 2019

Reimbursement Policies are available online

February 2019 Anthem Provider Newsletter - NV Reimbursement Policies Feb 1, 2019

Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred (Professional)

February 2019 Anthem Provider Newsletter - NV Reimbursement Policies Feb 1, 2019

Reminder: Review ICD-10-CM Coding Guidelines (Professional)

February 2019 Anthem Provider Newsletter - NV Reimbursement Policies Feb 1, 2019

Clear Claim Connection: our web-based claim edit tool

February 2019 Anthem Provider Newsletter - NV Reimbursement Policies Feb 1, 2019

Benefits to be available for chronic care management and advance care planning services effective February 23, 2019

January 2019 Anthem Provider Newsletter - NV Reimbursement Policies Jan 1, 2019

Reimbursement Policies are available online

January 2019 Anthem Provider Newsletter - NV Reimbursement Policies Jan 1, 2019

Clear Claim Connection

January 2019 Anthem Provider Newsletter - NV Reimbursement Policies Jan 1, 2019

Professional Reimbursement Policy Change and supporting claims editing notification for CMS-1500 submitters

December 2018 Anthem Important Updates - NV Reimbursement Policies Dec 1, 2018

Reimbursement for Convenience Surgical Supply Kits - Professional

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

Scope of License - Reimbursement Policy Update (Professional)

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

“Rule of Eight” Reporting Guidelines for Physical Medicine and Rehabilitation Services - Professional

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

System updates for reimbursement policies in 2019 - Professional

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

Modifier 79 - Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period - Professional

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

Reimbursement Policies are available online

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

Clear Claim Connection

December 2018 Anthem Provider Newsletter - NV Reimbursement Policies Dec 1, 2018

Assistant Surgery Services/Code List policy update - Professional

October 2018 Anthem Provider Newsletter - NV Reimbursement Policies Oct 1, 2018

Reimbursement Policies are available online

October 2018 Anthem Provider Newsletter - NV Reimbursement Policies Oct 1, 2018

Clear Claim Connection

October 2018 Anthem Provider Newsletter - NV Reimbursement Policies Oct 1, 2018

Reimbursement Policy Update - Claims requiring additional documentation (Facility)

September 2018 Anthem Provider Newsletter - NV Reimbursement Policies Aug 31, 2018

Reimbursement Policies are available online

September 2018 Anthem Provider Newsletter - NV Reimbursement Policies Aug 31, 2018

Clear Claim Connection

September 2018 Anthem Provider Newsletter - NV Reimbursement Policies Aug 31, 2018

Reimbursement Policies are available online

August 2018 Anthem Provider Newsletter - NV Reimbursement Policies Aug 17, 2018

Bundled Services and Supplies – Professional

August 2018 Anthem Provider Newsletter - NV Reimbursement Policies Aug 17, 2018

Once per Lifetime Procedures – Professional

August 2018 Anthem Provider Newsletter - NV Reimbursement Policies Aug 17, 2018

Clear Claim Connection

August 2018 Anthem Provider Newsletter - NV Reimbursement Policies Aug 17, 2018
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