Anthem – Claims Editing Update for ICD-10-CM Excludes1 Notes

Beginning with dates of service on or after January 1, 2022, Anthem Blue Cross and Blue Shield Healthcare Solutions will implement revised claims editing logic tied to Excludes1 notes from ICD-10-CM 2020 coding guidelines. To ensure the accurate processing of claims, use ICD-10-CM coding guidelines when selecting the most appropriate diagnosis for member encounters. Please remember to code to the highest level of specificity. For example, if there is an indication at the category level that a code can be billed with another range of codes, it is imperative to look for Excludes1 notes that may prohibit billing a specific code combination.

Source: https://providernews.anthem.com/nevada/article/claims-editing-update-for-icd-10-cm-excludes1-notes-2