BLUE REVIEW^SM

April 2024

Billing Guidelines for Laboratory Claims

Providers are encouraged to review the Ancillary Claim Submission information in the Commercial Provider Manual for Blue Cross and Blue Shield of Illinois to familiarize themselves with billing guidelines for independent clinical laboratory claims. Following these guidelines helps to ensure that claims are processed efficiently and accurately.

Quick Tips and Reminders
Submit laboratory claims for Blue Cross and Blue Shield members through the Plan state where samples were collected.

Maintain valid laboratory medical records. Records should be complete, legible, and include the following information:

• A signed valid requisition received from the physician or qualified health care provider who is treating the patient and will use the results in the management of the patient’s specific medical problem
• Documentation of the services ordered
• Results of the services performed

For more information, refer to the Commercial Provider Manual for BCBSIL or the BlueCard^® Program Provider Manual in our Standards and Requirements section.