ClaimsXtenTM Quarterly Update Effective April 11, 2022

Blue Cross and Blue Shield of Texas (BCBSTX) will implement its first quarter code updates for the ClaimsXten auditing tool on or after April 11, 2022.

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, BCBSTX may also post advance notice of significant changes, like implementation of new rules, in the News and Updates section of our provider website and the Blue Review monthly newsletter.

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 BCBSTX’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, refer to the Clear Claim Connection page in the Education and Reference/Provider Tools section of our provider website which includes a user guide and other details. In addition, review our ClaimsXten Rule Descriptions on the Coding, Billing and Bundling Information page.

 

ClaimsXten and Clear Claim Connection are trademarks of Change Healthcare, an independent company providing coding software to BCBSTX. Change Healthcare is solely responsible for the software and all the contents. BCBSTX 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 2021 American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the AMA.