Policy UpdatesCommercialMay 31, 2023

HCPCS to revenue code alignment – Evaluation/Management

Effective for all claims received on and after July 1, 2023, Anthem Blue Cross and Blue Shield (Anthem) is updating its outpatient facility editing system to align with correct coding guidelines. As a result, claims billed with HCPCS/CPT® codes 90833-90838, 99091-99499, and G0378-G0379 and an inappropriate revenue code(s) will be denied.

For assistance with coding guidelines, please refer to CPT coding guidelines and Encoder Pro.

If you believe you have received a denial in error, please follow the Anthem standard claim dispute process.

MULTI-BCBS-CM-025144-23-CPN24926

PUBLICATIONS: June 2023 Provider Newsletter