As a reminder, we will update our claim editing software monthly for professional services throughout 2021 with the majority of maintenance updates occurring quarterly in February, May, August and November. These updates will:

 

  • reflect the addition of new, and revised codes (e.g. CPT, HCPCS, ICD-10, modifiers) and their associated edits
  • include updates to National Correct Coding Initiative edits (NCCI) and medically unlikely edits (MUEs)
  • include updates to incidental, mutually exclusive, and unbundled (rebundle) edits
  • include assistant surgeon eligibility in accordance with the policy
  • include edits associated with reimbursement policies including, but not limited to, frequency edits, bundled services and global surgery preoperative and post-operative periods assigned by The Centers for Medicare & Medicaid Services (CMS)
  • apply to any provider, provider group (tax identification number) and/or across providers and claim type (professional/facility) for the same member


910-0121-PN-NE



Featured In:
January 2021 Anthem New Hampshire Provider News