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 (such as 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 (rebundle) 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 & 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 - Virginia