BCBS – Clinical Laboratory Improvement Amendments (CLIA) Number – Additional Information

The purpose of this article is to provide additional information regarding submission of the CLIA number on claims for laboratory services that include QW or 90 modifiers. As a reminder, claims filed without the CLIA number are considered incomplete and will reject. 

Both paper and electronic claim formats accommodate the CLIA number. 

• On the CMS-1500 form, Box 23 (Prior Authorization) is reserved for the CLIA number.
• On the 837P, REF segments are available: REF (X4) in loops 2300 and 2400, and REF (F4) in loop 2400. 

 Note: The CLIA number for the Referring Clinical Laboratory should be included in REF (F4)

Source: https://providernews.anthem.com/colorado/article/clinical-laboratory-improvement-amendments-clia-number-additional-information-1