CommercialMedicare AdvantageMedicaidAugust 1, 2024

August 2024 Provider Newsletter

Featured Articles

Medical Policy & Clinical GuidelinesCommercialAugust 1, 2024

MCG Care Guidelines 28th edition

Administrative

AdministrativeMedicare AdvantageAugust 1, 2024

ICD-10-CM Excludes1 notes

AdministrativeCommercialAugust 1, 2024

Device-dependent procedures — facility editing update

AdministrativeCommercialAugust 1, 2024

Incidental services — facility editing update

Digital SolutionsMedicare AdvantageJuly 16, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Digital SolutionsCommercialJuly 24, 2024

Expansion of Carelon Medical Benefits Management, Inc. programs

Digital SolutionsCommercialMedicare AdvantageMedicaidAugust 1, 2024

Save time and get better results with optimized CPT code search in Availity Essentials

Education & Training

Education & TrainingCommercialMedicare AdvantageMedicaidAugust 1, 2024

Coming soon: Provider e-Learning Resource Center for Payment Integrity

Education & TrainingCommercialMedicare AdvantageMedicaidAugust 1, 2024

August is National Breastfeeding Month

Education & TrainingMedicaidAugust 1, 2024

Topical fluoride for children

Policy Updates

Policy UpdatesMedicare AdvantageJuly 10, 2024

Clinical Criteria updates

Effective August 12, 2024

Medical Policy & Clinical GuidelinesMedicare AdvantageJuly 11, 2024

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialJuly 2, 2024

Updates to Carelon Medical Benefits Management Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesMedicaidJuly 11, 2024

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialAugust 1, 2024

Medical Policy and Clinical Guideline updates

Medical Policy & Clinical GuidelinesMedicare AdvantageJuly 5, 2024

Medical Policies and Clinical Utilization Management Guidelines update

Effective August 8, 2024

Prior AuthorizationCommercialAugust 1, 2024

Notification of authorization fax number changes

Prior AuthorizationMedicaidJune 27, 2024

Prior authorization requirement changes

Effective August 1, 2024
Codes L7510 and L7520

Prior AuthorizationMedicaidJune 27, 2024

Prior authorization requirement changes

Effective August 1, 2024
Code L5615

Prior AuthorizationMedicaidJuly 23, 2024

Prior authorization requirement changes

Effective September 1, 2024
Codes 33263, 33264, 64582, C2616, and S2095