March 9, 2026

ClaimsXten™ (CXT), an established claims auditing tool, used by BlueCross BlueShield or South Carolina, has been expanded to include a third phase, effective March 2026. Please note that CXT is not new. It was originally launched in March 2019 and continues to support accurate and compliant claims processing.

Purpose of CXT

CXT is designed to ensure claims are processed in alignment with:

• Current coding standards and guidelines from recognized medical societies
• National Correct Coding Initiative (NCCI) edits
• Industry best practices for accurate billing and reimbursement

What’s New – Phase 3 Enhancements

The newly implemented third phase introduces additional review rules and auditing capabilities, including but not limited to:

• Outpatient consultation coding guidelines
• Duplicate claim submissions by facilities
• Unbundled (unbundling) code pairs

These enhancements are intended to further improve claim accuracy, reduce billing errors, and ensure compliance with national coding standards.

Providers are encouraged to review the updated CXT guidelines, including Phase 3 changes. Be sure to assess internal billing and coding practices for alignment and educate staff on new and existing auditing rules to prevent claim denials or delays.

For questions or additional support, feel free to contact your Provider Relations Consultant.