Notification: ClaimsXtenTM 1st Quarter 2017 Updates

Posted December 19, 2016

Blue Cross and Blue Shield of Illinois (BCBSIL) reviews new and revised Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes on a quarterly basis. Codes are periodically added to or deleted from the ClaimsXten code auditing tool software by the software vendor and are not considered changes to the software version. BCBSIL will normally load this additional data to the BCBSIL claim processing system within 60 to 90 days after receipt from the software vendor and will confirm the effective date via the News and Updates section of the BCBSIL Provider website. Advance notification of updates to the ClaimsXten software version (i.e., change from ClaimsXten version 4.1 to 4.4) also will be posted on the BCBSIL Provider website.

Beginning on or after March 20, 2017, BCBSIL will enhance the ClaimsXten code auditing tool by adding the first quarter 2017 codes and bundling logic into our claim processing system.

To help determine how coding combinations on a particular claim may be evaluated during the claim adjudication process, you may continue to utilize Clear Claim ConnectionTM (C3). C3 is a free, online reference tool that mirrors the logic behind BCBSIL’s code-auditing software. Refer to Clear Claim Connection page in the Education and Reference Center/Provider Tools section for additional information on gaining access to C3, as well as answers to frequently asked questions about ClaimsXten. Additional information may be included in upcoming issues of the Blue Review.

ClaimsXten and Clear Claim Connection are trademarks of McKesson Information Solutions, Inc., an independent third party vendor that is solely responsible for its products and services.

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