MedicaidDocumentationMedium impact
Provider Reminder - CLIA Certificate Editing
Aetna Better Health of Virginia·VA·Policy Update
We identified it
Aug 13, 2026
Summary
Aetna Better Health of Virginia is reminding providers that laboratory claims must include valid and active CLIA certificate numbers to demonstrate compliance with federal laboratory testing requirements. Providers must submit CLIA numbers on all laboratory claims using the correct format: Loop 2300 REF01=X4 for electronic claims or Field 23 on CMS 1500 paper claims, with multiple items separated by hyphens or semicolons.
Action Required
Immediately: Billing team must audit all laboratory claims submitted to Aetna Better Health of Virginia to ensure CLIA certificate numbers are included and properly formatted. Update billing system templates and claims submission procedures to require CLIA number entry for all laboratory services. For electronic claims, configure system to populate Loop 2300 REF01=X4 with the provider's CLIA number. For paper CMS 1500 claims, ensure Field 23 includes CLIA certificate number(s) with hyphens or semicolons separating multiple items. Provide education to providers and front-desk staff on CLIA requirements and proper submission format. Non-compliance will result in claim denials for laboratory services lacking valid CLIA documentation.