January 13, 2023
Blue Cross and Blue Shield of Illinois (BCBSIL) will implement its first quarter code update for the ClaimsXten auditing tool on or after April 17, 2023.
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 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 simulates how BCBSIL’s code-auditing software works.
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.
CPT copyright 2023 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA.