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Optimum Healthcare policy

HEDIS Measurement Year (MY) 2020 Physician documentation guidelines and administrative codes

HEDIS Measurement Year (MY) 2020 Physician documentation guidelines and administrative codes is a public Optimum Healthcare policy. It lists 567 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

View the original policy (PDF) ↗

Payer
Optimum Healthcare
States
OH
Source
www.anthem.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes.

CodeOther Optimum Healthcare policies
00378Policies naming 00378
0500FPolicies naming 0500F
0501FPolicies naming 0501F
0502FPolicies naming 0502F
0503FPolicies naming 0503F
1111FPolicies naming 1111F
1123FPolicies naming 1123F
1124FPolicies naming 1124F
1125FPolicies naming 1125F
1126FPolicies naming 1126F
1157FPolicies naming 1157F
1158FPolicies naming 1158F
1159FPolicies naming 1159F
1160FPolicies naming 1160F
1170FPolicies naming 1170F
19180Policies naming 19180
19200Policies naming 19200
19220Policies naming 19220
19240Policies naming 19240
19303Policies naming 19303
19307Policies naming 19307
2022FPolicies naming 2022F
2023FPolicies naming 2023F
2024FPolicies naming 2024F
2025FPolicies naming 2025F
2026FPolicies naming 2026F
2033FPolicies naming 2033F
3044FPolicies naming 3044F
3046FPolicies naming 3046F
3051FPolicies naming 3051F
3052FPolicies naming 3052F
3060FPolicies naming 3060F
3061FPolicies naming 3061F
3062FPolicies naming 3062F
3066FPolicies naming 3066F
3074FPolicies naming 3074F
3075FPolicies naming 3075F
3077FPolicies naming 3077F
3078FPolicies naming 3078F
3079FPolicies naming 3079F
3080FPolicies naming 3080F
4010FPolicies naming 4010F
44388Policies naming 44388
44394Policies naming 44394
44401Policies naming 44401
44408Policies naming 44408
45330Policies naming 45330
45335Policies naming 45335
45337Policies naming 45337
45342Policies naming 45342
45346Policies naming 45346
45347Policies naming 45347
45349Policies naming 45349
45350Policies naming 45350
45378Policies naming 45378
45379Policies naming 45379
45380Policies naming 45380
45382Policies naming 45382
45384Policies naming 45384
45386Policies naming 45386
45388Policies naming 45388
45393Policies naming 45393
45398Policies naming 45398
45399Policies naming 45399
50340Policies naming 50340
50360Policies naming 50360
50365Policies naming 50365
50370Policies naming 50370
50380Policies naming 50380
57170Policies naming 57170
58300Policies naming 58300
59400Policies naming 59400
59409Policies naming 59409
59410Policies naming 59410
59425Policies naming 59425
59426Policies naming 59426
59430Policies naming 59430
59510Policies naming 59510
59514Policies naming 59514
59515Policies naming 59515
59610Policies naming 59610
59612Policies naming 59612
59614Policies naming 59614
59618Policies naming 59618
59620Policies naming 59620
59622Policies naming 59622
65091Policies naming 65091
65093Policies naming 65093
65101Policies naming 65101
65103Policies naming 65103
65105Policies naming 65105
65110Policies naming 65110
65112Policies naming 65112
65114Policies naming 65114
67028Policies naming 67028
67030Policies naming 67030
67031Policies naming 67031
67036Policies naming 67036
67039Policies naming 67039
67043Policies naming 67043
67101Policies naming 67101
67105Policies naming 67105
67107Policies naming 67107
67108Policies naming 67108
67110Policies naming 67110
67113Policies naming 67113
67121Policies naming 67121
67141Policies naming 67141
67145Policies naming 67145
67208Policies naming 67208
67210Policies naming 67210
67218Policies naming 67218
67220Policies naming 67220
67221Policies naming 67221
67227Policies naming 67227
67228Policies naming 67228
72020Policies naming 72020
72052Policies naming 72052
72100Policies naming 72100
72110Policies naming 72110
72114Policies naming 72114
72120Policies naming 72120
72131Policies naming 72131
72133Policies naming 72133
72141Policies naming 72141
72142Policies naming 72142
72146Policies naming 72146
72149Policies naming 72149
72156Policies naming 72156
72158Policies naming 72158
72200Policies naming 72200
72202Policies naming 72202
72220Policies naming 72220
74261Policies naming 74261
74263Policies naming 74263
76801Policies naming 76801
76805Policies naming 76805
76811Policies naming 76811
76813Policies naming 76813
76815Policies naming 76815
76821Policies naming 76821
76825Policies naming 76825
76828Policies naming 76828
76977Policies naming 76977
77061Policies naming 77061
77063Policies naming 77063
77065Policies naming 77065
77067Policies naming 77067
77078Policies naming 77078
77080Policies naming 77080
77081Policies naming 77081
77085Policies naming 77085
77086Policies naming 77086
80047Policies naming 80047
80048Policies naming 80048
80050Policies naming 80050
80053Policies naming 80053
80055Policies naming 80055
80069Policies naming 80069
80081Policies naming 80081
81000Policies naming 81000
81003Policies naming 81003
81005Policies naming 81005
81528Policies naming 81528
82042Policies naming 82042
82044Policies naming 82044
82270Policies naming 82270
82274Policies naming 82274
82947Policies naming 82947
82950Policies naming 82950
82951Policies naming 82951
83036Policies naming 83036
83037Policies naming 83037
84156Policies naming 84156
86694Policies naming 86694
86777Policies naming 86777
86778Policies naming 86778
86900Policies naming 86900
86901Policies naming 86901
87620Policies naming 87620
87622Policies naming 87622
87624Policies naming 87624
87625Policies naming 87625
88141Policies naming 88141
88143Policies naming 88143
88147Policies naming 88147
88148Policies naming 88148
88150Policies naming 88150
88152Policies naming 88152
88153Policies naming 88153
88164Policies naming 88164
88167Policies naming 88167
88174Policies naming 88174
88175Policies naming 88175
90633Policies naming 90633
90644Policies naming 90644
90647Policies naming 90647
90648Policies naming 90648
90649Policies naming 90649
90650Policies naming 90650
90651Policies naming 90651
90655Policies naming 90655
90657Policies naming 90657
90661Policies naming 90661
90670Policies naming 90670
90673Policies naming 90673
90680Policies naming 90680
90681Policies naming 90681
90685Policies naming 90685
90686Policies naming 90686
90687Policies naming 90687
90688Policies naming 90688
90689Policies naming 90689
90698Policies naming 90698
90700Policies naming 90700
90706Policies naming 90706
90707Policies naming 90707
90710Policies naming 90710
90713Policies naming 90713
90715Policies naming 90715
90716Policies naming 90716
90721Policies naming 90721
90723Policies naming 90723
90734Policies naming 90734
90740Policies naming 90740
90744Policies naming 90744
90747Policies naming 90747
90748Policies naming 90748
90791Policies naming 90791
90792Policies naming 90792
90832Policies naming 90832
90834Policies naming 90834
90836Policies naming 90836
90840Policies naming 90840
90845Policies naming 90845
90847Policies naming 90847
90849Policies naming 90849
90853Policies naming 90853
90863Policies naming 90863
90870Policies naming 90870
90875Policies naming 90875
90876Policies naming 90876
90935Policies naming 90935
90937Policies naming 90937
90945Policies naming 90945
90947Policies naming 90947
90997Policies naming 90997
90999Policies naming 90999
92002Policies naming 92002
92004Policies naming 92004
92012Policies naming 92012
92014Policies naming 92014
92018Policies naming 92018
92019Policies naming 92019
92134Policies naming 92134
92201Policies naming 92201
92202Policies naming 92202
92227Policies naming 92227
92228Policies naming 92228
92230Policies naming 92230
92235Policies naming 92235
92240Policies naming 92240
92250Policies naming 92250
92260Policies naming 92260
93784Policies naming 93784
93788Policies naming 93788
93790Policies naming 93790
97110Policies naming 97110
97112Policies naming 97112
97113Policies naming 97113
97124Policies naming 97124
97140Policies naming 97140
97161Policies naming 97161
97164Policies naming 97164
97802Policies naming 97802
97804Policies naming 97804
98925Policies naming 98925
98929Policies naming 98929
98940Policies naming 98940
98942Policies naming 98942
98960Policies naming 98960
98962Policies naming 98962
98966Policies naming 98966
98968Policies naming 98968
98970Policies naming 98970
98971Policies naming 98971
98972Policies naming 98972
99078Policies naming 99078
99091Policies naming 99091
99201Policies naming 99201
99202Policies naming 99202
99203Policies naming 99203
99205Policies naming 99205
99211Policies naming 99211
99213Policies naming 99213
99215Policies naming 99215
99217Policies naming 99217
99218Policies naming 99218
99219Policies naming 99219
99220Policies naming 99220

And 267 more in the original policy.

All Optimum Healthcare policies

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.

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