February 2021
Medicaid Reminder: Claims with Non-Covered Revenue Codes Will Be Denied
This reminder applies to hospital providers, Illinois Department of Healthcare and Family Services (HFS) type 30, 31 and 32, who submit claims to Blue Cross and Blue Shield of Illinois (BCBSIL) for our Blue Cross Community Health PlansSM (BCCHPSM) members.
BCBSIL has aligned its claim coding with HFS regarding covered and non-covered revenue codes for Medicaid claims.
HFS maintains a list of non-covered revenue codes. Billing with these codes will result in a claim rejection.
The Illinois Association of Medicaid Health Plans (IAMHP) also provides an additional resource for hospital providers. Guidance can be found on page 90 of the IAMHP manual.
Contact our Customer Service at 877-860-2837 or your assigned Provider Network Consultant (PNC) with questions.
The material presented here is for informational/educational purposes only, is not intended to be medical advice or a definitive source for coding claims and is not a substitute for the independent medical judgment of a physician or other health care provider. Health care providers are encouraged to exercise their own independent medical judgment based upon their evaluation of their patients’ conditions and all available information, and to submit claims using the most appropriate code(s) based upon the medical record documentation and coding guidelines and reference materials. References to other third-party sources or organizations are not a representation, warranty or endorsement of such organization. Any questions regarding those organizations should be addressed to them directly.