Physician office lab list update effective January 1, 2019

As a reminder, the physician office lab (POL) lists include one list for primary care providers (PCPs) and one for specialist care providers (SCPs).  These lists include services for office-based tests for members enrolled in Anthem HealthKeepers and Anthem HealthKeepers Plus (Medicaid) – health benefit plans offered by Anthem’s affiliate HealthKeepers, Inc.  PCPs and SCPs who provide these services during an office visit for a covered member can submit claims for these services directly to HealthKeepers, Inc. for reimbursement. Lab tests not shown on these lists are not reimbursable to providers and must be handled by our exclusive arrangement with laboratory provider, LabCorp.  

 

POL list for SCPs expands to include CPT 87631 effective January 1

 

In this notice, HealthKeepers, Inc. is announcing that our POL list for SCPs has been expanded to include CPT 87631. [CPT code 87631 is defined as respiratory virus (e.g., adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets.]  

 

This change became effective January 1, 2019.  For the complete POL list, visit anthem.com and select providers and then “Find Resources for Virginia.”  On the Provider home page, select the “Answers@Anthem” tab at the top and then the “Provider Office Lab Lists” link.