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Two New Claims Editing Rules To Be Implemented in July 2026
BCBS Montana·MT·Reimbursement
Effective date
Jul 8, 2026
We identified it
Jun 18, 2026
Summary
Blue Cross Blue Shield of Montana will implement two new claims editing rules in July 2026 that will automatically deny claims with coding errors. The first rule checks for mismatched laterality modifiers (LT/RT/50) with diagnoses, and the second validates HCPCS codes used with implant revenue codes 275, 276, and 278.
Action Required
By July 8, 2026: Billing team must review and validate all claims for proper laterality modifier usage (LT, RT, 50) to ensure they match diagnoses before submission. For facility claims, verify HCPCS codes used with implant revenue codes 275, 276, and 278 are appropriate. Use Clear Claim Connection (C3) software to test coding combinations before claim submission. Claims with these errors will be automatically denied with 'G' reason codes.