BCBS – Clarification for Billing COVID-19 Testing – Provider Alert

Effective Oct. 1, 2020, Blue Cross and BCN commercial claims processing systems have been updated to reject diagnosis code Z11.59 when billed with a COVID-19 lab test. Z11.59 is a diagnosis code used for screening for other viral diseases. When Z11.59 is used for COVID-19 testing, Blue Cross assumes the test to be screening for an asymptomatic, non-exposed patient, and not for pre-operative or other clinical indications as determined by the provider, and will deny payment for our commercial products.

Follow guidance from the Centers for Medicare & Medicaid Services for Medicare Advantage plans.

BCBS previously published guidelines for billing pre-operative COVID-19 testing, which includes four diagnosis codes that should be used: Z01.810, Z01.811, Z01.812 or Z01.818.

Source: https://www.bcbsm.com/content/dam/public/shared/documents/coronavirus/provider/alerts/billing-clarification.pdf