Claim Edits 251 and B57
Sept. 26, 2018
BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan recently made changes for BlueCross member IDs. These changes impacted claims that have not been submitted with the correct carrier code based on members’ ID prefix.
Previously, these claims would have been accepted and routed accordingly. Now, due to new member ID requirements, claims must be submitted with the carrier code (payer ID) which corresponds correctly to the members’ ID prefix. Claims submitted with the incorrect carrier code will return either a 251 or B57 edit.
Please use this chart as a reference.
| Plan Name | Member ID Prefix | Payer ID |
| BlueCross BlueShield of South Carolina Preferred BlueSM and BlueEssentialsSM (also includes all out-of state BlueCard members) | All prefixes except those listed below. | 401 |
| BlueChoice® HealthPlan and Blue Option | ZCC, ZCG, ZCI, ZCJ, ZCL, ZCX (termed 12/31/2016) | 922 |
| State Health Plan | ZCK, ZCS | 400 |
| Federal Employee Program (FEP) | “R” | 402 |
| Medicare Advantage (BlueCross TotalSM and BlueCross SecureSM ) |
ZHP, ZOH, ZOM | C63 |
| Planned Administrators (PAI) | 8 digits (usually begins with a “1”) | 886 |
| Thomas Cooper | TC | 315 |
| BlueChoice HealthPlan Medicaid (Healthy BlueSM) | ZCD | 00403 |
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Note: Medical claims clearinghouses have their own proprietary Payer ID list. Check with your clearinghouse for the Payer ID you should use for BlueCross BlueShield of South Carolina plans. |
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A notification of this change was sent previously to our trading partners. If you have any questions or concerns please contact our EDI area at edi.services@bcbssc.com.
BlueChoice HealthPlan of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.