BCBS Anthem – Genetic Testing claim edits

For professional claims submitted on a CMS-1500 form processed on or after April 26, 2023, Anthem Blue Cross and Blue Shield will enhance our editing systems to automate edits and simplify remittance messaging. These edit enhancements are supported by correct coding guidelines, as documented in industry sources such as Correct Procedural Terminology (CPT^®) guidelines and Centers for Medicare & Medicaid Services (CMS). Additionally, these edit enhancements will promote faster claim processing and reduce follow-up audits and/or record requests for claims that are not consistent with correct coding guidelines. As a result of these edit enhancements, there will be greater attention on identifying inappropriate billing of genetic testing services.

Source: https://providernews.anthem.com/new-hampshire/article/genetic-testing-claim-edits