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Additional Code-auditing Software Scheduled for Implementation as of April 23, 2017

Posted December 21, 2016

Blue Cross and Blue Shield of Illinois (BCBSIL) will be implementing an additional code-auditing software system, effective April 23, 2017.* This software will further enhance the auditing of professional and outpatient facility claims for correct coding according to Healthcare Common Procedure Coding System (HCPCS), Current Procedural Terminology (CPT®) and Centers for Medicare & Medicaid Services (CMS) guidelines. Upon implementation, providers may use the Claim Inquiry Resolution tool, available on the AvailityTM Web Portal, to research specific claim edits. For additional information, watch the Blue Review, as well as the News and Updates section. 

*The above notice does not apply to government programs claims.

CPT copyright 2016 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA.

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services offered by third party vendors such as Availity. If you have any questions about the products or services offered by such vendors, you should contact the vendor(s) directly.