As a reminder, we will update our claim editing software monthly throughout 2020 with the most common updates occurring in quarterly in February, May, August and November of 2020. 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 (NCCI) edits
  • Include updates to incidental, mutually exclusive, and unbundled (rebundled) edits
  • Include assistant surgeon eligibility in accordance with the policy
  • Include edits associated with reimbursement policies including, but not limited to, frequency edits, medically unlikely edits, bundled services and global surgery preoperative and post-operative periods assigned by The Centers for Medicare and Medicaid Services (CMS)
  • Apply to any provider or provider group (tax identification number) and may apply to both institutional and professional claim types


Featured In:
December 2019 Anthem Provider News - Ohio