Anthem to Enhance Claim Edits for Outpatient Facility Claims

Beginning in April 2019, Anthem will enhance its claims editing systems to include outpatient facility editing. These edits will: 

• Help ensure correct coding and billing practices are being followed
• Help ensure compliance with industry standards such as Centers for Medicare & Medicaid Services (CMS), American Medical Association (AMA), National Uniform Billing Committee (NUBC), and national specialty and academy guidelines
• Reinforce compliance with standard code edits and rules (i.e., CPT, HCPC, ICD-10, NUBC)