December 30, 2021
The ClaimsXten code auditing tool is updated quarterly. On or after April 11, 2022, Blue Cross and Blue Shield of Illinois (BCBSIL) will implement the first quarter code update in the ClaimsXten tool.
These quarterly code updates aren’t considered changes to the software version. Code updates may include additions, deletions and revisions to:
- Current Procedural Terminology (CPT®) codes
- Healthcare Common Procedure Coding System (HCPCS) codes
When applicable, BCBSIL may also post advance notice of significant changes, like implementation of new rules, in the News and Updates section of our Provider website. Information also may be included in the Blue Review.
Use Clear Claim ConnectionTM (C3) to determine how certain coding combinations may be adjudicated when we process your claim. C3 is a free, online reference tool that mirrors the logic behind BCBSIL’s code-auditing software.
Please note that C3 doesn’t contain all of our claim edits and processes. Its results don’t guarantee the final claim decision.
For more information on C3 and ClaimsXten, refer to the Clear Claim Connection page. It includes a user guide, rule descriptions and other details.
This article doesn’t apply to government programs (Medicare Advantage and Illinois Medicaid) member claims.
ClaimsXten and Clear Claim Connection are trademarks of Change Healthcare, an independent company providing coding software to BCBSIL. Change Healthcare is solely responsible for the software and all the contents. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Change Healthcare. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.
CPT copyright 2020 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA.