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New Claims Editing Rules To Be Implemented in July 2026
Effective date
Jul 15, 2026
Identified
May 3, 2026
Summary
Blue Cross Blue Shield of Texas is implementing new claims editing rules in July 2026 that will automatically deny or rebundle claims for various coding scenarios. Claims receiving these edits will show ineligible reason codes with an alpha character 'G' and affect multiple specialties including radiation therapy, STI testing, colonoscopy procedures, and hospital billing.
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What to do
Action · 4 steps
01Before July 15, 2026: Billing team must review and update coding practices for affected procedures.
02Use Clear Claim Connection software to test coding combinations before claim submission.
03Update billing system rules to prevent denials for: STI testing bundling (use 87801 for multiple tests), colonoscopy injection billing with biopsies, hospital discharge/admit same-day billing, and ensure proper modifiers for anesthesia and bilateral procedures.
04Train staff on new editing rules to avoid automatic claim denials.
Codes mentioned
7730187491875918766187801J92994538145383453844538545388G6024969209692196922
Original notice
New Claims Editing Rules To Be Implemented in July 2026
bcbstx.com · Always check the source before changing claims.
Related changes
See all BCBS Texas changes →Related policy hubs
BCBS Texas policiesTX policy changesRadiation OncologyGastroenterologyEmergency MedicineAnesthesiologyUrologyOB-GYNInfectious DiseaseNephrologyDermatologyGeneral SurgeryCode 77301Code 87491Code 87591Code 87661Code 87801Code J9299Code 45381Code 45383Code 45384Code 45385Code 45388Code G6024Code 96920Code 96921Code 96922