Quarterly Claim Editing Update: Fourth Quarter 2019
Horizon BCBSNJ is presently upgrading one of the primary source systems we use to carry out our quarterly claim editing updates. As a result, the implementation of certain fourth quarter (Q4) claim edit changes/updates will be delayed until January 2020. Details about this delayed implementation will be provided later this year.
Q4 claim editing updates related to rules/guidelines implemented by the Centers for Medicare & Medicaid Services (CMS) National Correct Coding Initiative (NCCI) were implemented on October 1, 2019 for patients enrolled in fully insured and Medicare Advantage plans only¹. Details of these updates may be accessed by visiting the following CMS web pages:
If you have questions, call Physician Services at 1-800-624-1110 or Institutional Services at 1-888-666-2535, Monday through Friday, from 8 a.m.to 5 p.m., Eastern Time.
Read more about our Claim Editing Policies.
¹These Q4 NCCI claim edit updates will be implemented with the delayed Q4 claim edit changes/updates for patients enrolled in Administrative Services Only (ASO) including State Health Benefits Program (SHBP)/School Employees’ Health Benefits Program (SEHBP) plans.