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Enhanced Review of Laboratory, Genetic and Molecular Testing Claims
Oct. 26, 2026
Effective Feb. 1, 2027, we’ll enhance our claims editing process for laboratory, genetic and molecular testing to better align coding with industry standards for accurate billing and proper reimbursement for many commercial members.
What’s changing: Your claims for laboratory, genetic and and molecular testing services will be reviewed for dates of service beginning Feb. 1, 2027, using American Medical Association and Centers for Medicare & Medicaid Services National Correct Coding Initiative guidelines to determine whether your claim includes proper coding.
These claims will be reviewed by Concert, a healthcare technology company, for proper coding. If your claim is denied, you will receive a letter with next steps.
What this means for you: Please continue to follow AMA and CMS guidelines. This enhanced claims review process will help ensure claims are processed accurately. This change should not increase response times.
Watch News and Updates for future updates.
Concert is an independent company that has contracted with Blue Cross and Blue Shield of Oklahoma to provide utilization management services for members with coverage through BCBSOK. BCBSOK makes no endorsement, representations or warranties regarding third party vendors and the products and services offered by them.
The information provided does not constitute coding or legal advice. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials.