June 2023

ClaimsXten™ Quarterly Update Effective Aug. 21, 2023

Blue Cross and Blue Shield of Oklahoma (BCBSOK) will implement its second and third quarter code updates for the ClaimsXten auditing tool on or after Aug. 21, 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, BCBSOK 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 Connection™ (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 BCBSOK’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 for more information on C3 and ClaimsXten. It includes a user guide, rule descriptions and other details.

ClaimsXten Announces Software Version Upgrade

Beginning on or after July 10, 2023, BCBSOK will perform a system software upgrade for ClaimsXten from version 6.0 to version 7.0.

Key enhancements include a new look and feel for the C3 tool, with new data fields for greater claim specificity. The ICD code set default will now be ICD-10.

Note: Clinical edit clarifications and related sources will continue to be available.

Refer to our Clear Claim Connection Provider Tools page for more details regarding ClaimsXten, including a user guide, rule descriptions and other details.

MoreInformation: Watch for future updates in our monthly issues of the Blue Review.

ClaimsXten and Clear Claim Connection are trademarks of Change Healthcare, an independent company providing coding software to BCBSOK. Change Healthcare is solely responsible for the software and all the contents.

Checks of eligibility and/or benefit information are not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered.