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Claim Submission Criteria for Medical Claims on CMS 1500 Form

Provider Administrative Policy

General Information
Policy Date
September 2013
New/ September 2013
Provider Type(s)
All Providers  


Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Blue Cross of Idaho works diligently on behalf of our members to develop contracting relationships with Idaho dental providers and Blue Cross Blue Shield dental affiliates (national Dental Grid).



Claim Submission Criteria for Medical Claims on CMS 1500 Form

Blue Cross of Idaho does not accept claims submitted on a CMS 1500 Claim Form with a combination of CPT procedure codes and CDT codes. We will return claims received with a combination of codes for correct coding. Filing claims under a member's medical policy can be done using the CMS 1500 Form. This form requires the use of CPT procedure codes and ICD-9 diagnostic codes.

Policy History

Date Action Reason