Clinical Laboratory Improvement Amendments for Anthem Blue Cross and Blue Shield

To be considered for reimbursement of clinical laboratory services, a valid CLIA certificate identification number must be reported on a 1500 Health Insurance Claim Form (CMS-1500) or its electronic equivalent effective July 1, 2015.

Laboratory procedures are only covered and, therefore, payable if rendered by an appropriately licensed or certified laboratory having the appropriate level of CLIA accreditation for the particular test performed. Thus, any claim that does not contain the CLIA ID, has an invalid ID, has a lab accreditation level that does not support the billed service code and/or does not have complete servicing provider demographic information will be considered incomplete and rejected or denied beginning November 1, 2019.

Source: https://www11.anthem.com/shared/noapplication/f0/s0/t0/pw_g374375.pdf?refer=ahpprovider&state=oh