As we previously communicated, Independence Blue Cross (IBX) is moving our core business to a new claims processing platform. As part of this transition, the alpha numeric claim message codes associated with the Enhanced Claim Editor Program are changing from E8xxx message codes to ECExxxx message codes.
While the remittance messaging is changing, the core principles of the enhanced editing program remain the same. That means ensuring compliance with correct coding guidelines as endorsed by national and regional industry sources, including but not limited to:
- Centers for Medicare & Medicaid Services (CMS) standards such as:
- National Coverage Determinations (NCDs)
- Local Coverage Determinations (LCDs)
- Medicare Claims Processing Manual
- National Correct Coding Initiative (NCCI) Edits
- Durable Medical Equipment Regional Carries (DMERC) Manual
- CMS Healthcare Common Procedure Coding System (HCPCS) LEVEL II Manual coding guidelines
- American Medical Association (AMA) Current Procedural Terminology (CPT®) coding guidelines
- International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) Official Guidelines for Coding and Reporting
- Food and Drug Administration (FDA)
- Nationally recognized specialty societies such as:
- National Comprehensive Cancer Network (NCCN)
- American College of Obstetricians and Gynecologists (ACOG)
- U.S. Preventive Services Task Force (USPSTF)
Questions
For questions related to a claim line with a message code that begins with an ECE, please submit a Claim Investigation request via the Claim Search transaction in Practice Management on the Provider Engagement, Analytics & Reporting (PEAR) portal. Your submission will be routed directly to an associate specialized in answering questions related to the Enhanced Claim Editor Program.
For assistance with using transactions on the PEAR portal, contact PEAR support at 1-833-444-PEAR (1-833-444-7327).
Look for future articles related to the Enhanced Claim Editor Program and our transition to the new claim processing platform. Visit our dedicated Platform Transition page to stay informed.
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