If you are a NY provider that accepts Anthem BCBS members in your practice and performs telehealth services, then this blog post is for you!

Starting on 9/1/26 and for any DOS thereafter the telehealth claims will be subject to Excludes 1 (in ICD-10-CM) notes.

In order to avoid any issues with claim payment please make sure that your office:

• Reviews the Excludes 1 notes
• Code to the highest level of specificity
• Verify that codes that are billed on the claim are no prohibited from being billed together.
• Codes that have Excludes 1 note should not be billed/coded together

Please note that member benefit/coverage for telehealth is not affected by this update.

Have you received a denial of the claim in error?

• Follow standard appeals process- submit any supporting documents via Availity Privider portal

Find this information useful? Follow me for more payer updates. #medicalbilling

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