CommercialDecember 30, 2022

January 2023 Newsletter

Administrative

AdministrativeCommercialDecember 30, 2022

Empire BlueCross BlueShield local precertification change in New York

AdministrativeCommercialDecember 30, 2022

Professional system updates for 2023

AdministrativeCommercialMedicare AdvantageMedicaidDecember 30, 2022

Engagement with your patient counts

AdministrativeCommercialMedicaidDecember 30, 2022

Childhood Immunization Status and Lead Screening in Children for HEDIS

AdministrativeCommercialDecember 30, 2022

Outpatient system updates for 2023

AdministrativeCommercialDecember 30, 2022

Remittance advice message enhancements: Providing clear descriptions and actionable next steps

AdministrativeCommercialDecember 30, 2022

Empire BlueCross BlueShield local precertification change in New York

AdministrativeCommercialDecember 30, 2022

Outpatient facility revenue code billing requirements

Policy Updates

Medical Policy & Clinical GuidelinesCommercialDecember 30, 2022

Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List

Medical Policy & Clinical GuidelinesCommercialMedicare AdvantageMedicaidDecember 30, 2022

Updates to AIM Specialty Health Musculoskeletal - Interventional Pain Management Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesMedicaidDecember 30, 2022

Monkeypox and smallpox vaccines: Product code on claims

Medical Policy & Clinical GuidelinesCommercialMedicaidDecember 30, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialDecember 30, 2022

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines

Medical Policy & Clinical GuidelinesCommercialDecember 30, 2022

Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines 

Medical Policy & Clinical GuidelinesCommercialDecember 30, 2022

Medical Policy and Clinical Guidelines updates

Reimbursement PoliciesCommercialMedicare AdvantageDecember 30, 2022

Notification regarding reimbursement changes to COVID-19 laboratory services codes
Material Adverse Change (MAC)

Products & Programs

Federal Employee Program (FEP)CommercialDecember 30, 2022

Federal Employee Program observation conversion for musculoskeletal cases

PharmacyCommercialDecember 30, 2022

Specialty pharmacy updates

State & Federal

State & FederalMedicaidDecember 30, 2022

Use of modifier 25 when billing for visits that include preventive services and problem-oriented evaluation and management services

State & FederalMedicaidDecember 30, 2022

Keep up with Medicaid news - January 2023
View these Medicaid articles:

State & FederalMedicare AdvantageDecember 30, 2022

Keep up with Medicare news - January 2023
View these Medicare articles: