03/28/2024
Effective July 1, 2024, CPCP025 Corrected Claim Submission will be updated with changes that include submitting added and late charges as a corrected claim after the original claim has been processed.
What are Late Charges?
Late charges or additional charges, represent changes for items and services that were submitted after the bill was created and not included in the original bill.
Submitting a Corrected Claim
The corrected claim should include all line items previously processed correctly. Reimbursement for line items no longer included on the corrected claim may be subject to recoupment by the plan.
Using Frequency Codes
When submitting a corrected facility claim for added and/or late charges to an inpatient or outpatient claim, the entire claim should be resubmitted with frequency code 7 (replacement of prior claim). Do not submit a corrected claim using frequency code 5 (late charges). If the corrected claim is submitted using frequency code 5, this could result in a delay in processing and denial of the claim and require the claim to be resubmitted with frequency 7.
Refer to our revised CPCP025 Corrected Claim Submissions Policy on our Clinical Payment and Coding Policies page on the provider website for more information.
If you have any questions or if you need additional information, please contact your BCBSTX Network Management Representative.
Clinical payment and coding policies are based on using healthcare professionals and industry standard guidelines. The clinical payment and coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers.