Medicare AdvantageAdministrativeMedium impact
MAPAP236 - Outpatient Code Edits and Remittance Advice Codes - Removed number of edits.
Blue Cross of Idaho·ID·Coding
Effective date
Jul 1, 2026
We identified it
Jul 28, 2026
Summary
Blue Cross of Idaho removed a specific number of Outpatient Code Editor (OCE) edits from policy MAPAP236 effective July 2026. The policy continues to apply OCE edits to all Medicare Advantage outpatient facility claims, with detailed explanation codes mapped to each edit. However, the exact quantity and specific edits that were removed are not detailed in this policy document.
Action Required
By July 1, 2026: Billing team should contact Blue Cross of Idaho Provider Relations directly to obtain the specific list of OCE edits that were removed from the policy. Review current claim denials and suspensions in the system to identify any that may be affected by the removed edits. Update internal billing documentation and claim scrubbing logic if specific edits are no longer applicable. Monitor remittance advice reports for changes in edit-related denial patterns. Verify that claims previously denied under removed edits are now processed correctly going forward.