Wisconsin
Provider Communications

Articles Month: December 2022

Title Publication Category Date

Notification regarding reimbursement changes to COVID-19 laboratory services codes*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Administrative Dec 30, 2022

Engagement with your patient counts

January 2023 Anthem Provider News - Wisconsin Administrative Dec 30, 2022

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT code list update*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines *

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 30, 2022

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

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 30, 2022

Specialty pharmacy updates*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Pharmacy Dec 30, 2022

Attention physicians and lab providers: COVID-19 update regarding reimbursement

January 2023 Anthem Provider News - Wisconsin Medicaid Dec 30, 2022

Childhood Immunization Status and Lead Screening in Children for HEDIS

January 2023 Anthem Provider News - Wisconsin Medicaid Dec 30, 2022

Monkeypox and smallpox vaccines: Product code on claims

January 2023 Anthem Provider News - Wisconsin Medicaid Dec 30, 2022

Keep up with Medicaid News - January 2023

- This is Quitting: Helping teens and young adults quit vaping
- Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines
January 2023 Anthem Provider News - Wisconsin Medicaid Dec 30, 2022

Keep up with Medicare news - January 2023

- Prior authorization requirement changes
- New specialty pharmacy medical step therapy requirements (Inflectra & Renflexis)
- Anthem Blue Cross and Blue Shield expands specialty pharmacy precertification list (Cimerli)
- Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines
January 2023 Anthem Provider News - Wisconsin Medicare Dec 30, 2022

Federal Employee Program observation conversion for musculoskeletal cases*

*Material adverse change (MAC)
January 2023 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Dec 30, 2022

Cleveland-Cliffs offers Medicare Advantage option

January 2023 Anthem Provider News - Wisconsin Medicare Dec 30, 2022

Submitting prior authorizations digitally through Interactive Care Reviewer

January 2023 Anthem Provider News - Wisconsin Digital Tools Dec 30, 2022

Outpatient facility revenue code billing requirements

January 2023 Anthem Provider News - Wisconsin Reimbursement Policies Dec 30, 2022

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

January 2023 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 30, 2022

Professional system updates for 2023

January 2023 Anthem Provider News - Wisconsin Administrative Dec 30, 2022

Outpatient system updates for 2023

January 2023 Anthem Provider News - Wisconsin Administrative Dec 30, 2022

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

January 2023 Anthem Provider News - Wisconsin Administrative Dec 30, 2022

Childhood Immunization Status and Lead Screening in Children for HEDIS

January 2023 Anthem Provider News - Wisconsin Administrative Dec 30, 2022

Attention lab providers: COVID-19 update regarding reimbursement*

*Material Adverse Change (MAC)
December 2022 Anthem Provider News - Wisconsin Administrative Dec 1, 2022

Coordination of care

December 2022 Anthem Provider News - Wisconsin Administrative Dec 1, 2022

Case management program

December 2022 Anthem Provider News - Wisconsin Administrative Dec 1, 2022

Important information about utilization management

December 2022 Anthem Provider News - Wisconsin Administrative Dec 1, 2022

IngenioRx will become CarelonRx on January 1, 2023

December 2022 Anthem Provider News - Wisconsin Administrative Dec 1, 2022

Specialty pharmacy updates - December 2022*

*Material adverse change (MAC)
December 2022 Anthem Provider News - Wisconsin Pharmacy Dec 1, 2022

AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update*

*Material adverse change (MAC)

December 2022 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2022

Medical Policies and Clinical Guidelines updates - December 2022*

*Material adverse change (MAC)
December 2022 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2022

Reimbursement policy retirement: Acupuncture Billed with Evaluation and Management - Professional

December 2022 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Bundled Services and Supplies - Professional*

*Material adverse change (MAC)

December 2022 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

*Material adverse change (MAC)

December 2022 Anthem Provider News - Wisconsin Reimbursement Policies Dec 1, 2022

Keep up with Medicaid News - December 2022

- Prior authorization requirement changes effective January 1, 2023
- Medical drug benefit Clinical Criteria updates
- Medical Policies and Clinical Utilization Management Guidelines update
- Prior authorization updates for medications billed under the medical benefit (Releuko, Vabysmo)
- Signature requirements for laboratory orders or requisitions
December 2022 Anthem Provider News - Wisconsin Medicaid Dec 1, 2022

Keep up with Medicare News - December 2022

- Medical Policies and Clinical Utilization Management Guidelines update
- Signature requirements for laboratory orders or requisitions
December 2022 Anthem Provider News - Wisconsin Medicare Dec 1, 2022

2023 Medicare Advantage service area and benefit updates

December 2022 Anthem Provider News - Wisconsin Medicare Dec 1, 2022

Member assessment of PCP after-hours messaging in 2022

December 2022 Anthem Provider News - Wisconsin Administrative Dec 1, 2022

Member’s assessment of behavioral healthcare after-hours messaging in 2022

December 2022 Anthem Provider News - Wisconsin Administrative Dec 1, 2022

Members’ rights and responsibilities

December 2022 Anthem Provider News - Wisconsin Administrative Dec 1, 2022

CAA: Timely updates help keep our provider directories current

December 2022 Anthem Provider News - Wisconsin Administrative Dec 1, 2022

Clinical practice and preventive health guidelines available on anthem.com

December 2022 Anthem Provider News - Wisconsin Administrative Dec 1, 2022

Signature requirements for laboratory orders or requisitions

December 2022 Anthem Provider News - Wisconsin Administrative Dec 1, 2022

Pharmacy information available on the provider website

December 2022 Anthem Provider News - Wisconsin Pharmacy Dec 1, 2022

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update

December 2022 Anthem Provider News - Wisconsin Medical Policy & Clinical Guidelines Dec 1, 2022

Personal home helper benefit ending

December 2022 Anthem Provider News - Wisconsin Medicare Dec 1, 2022
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