CommercialAdministrativeHigh impact
AB2026-06-001 Updates and new information
Capital Blue Cross·PA · Pediatrics·Provider News
Effective date
Jul 1, 2026
We identified it
Jun 20, 2026
Summary
Capital Blue Cross is implementing multiple changes including a new claim rejection code C1167I for misrouted claims (effective August 1, 2026), transitioning closed-claim letters to electronic format, covering environmental lead investigations for CHIP members, and removing preauthorization requirements for certain genetic testing codes.
Action Required
By August 1, 2026: Billing team must update systems to handle new rejection code C1167I and verify member home plans before submitting claims. By August 1, 2026: Set up access to Electronic Closed Letter Detail (eCLD) files via Availity Essentials for closed-claim notifications. Immediately: Remove preauthorization requirements for CPT codes 81412 and 81443 for genetic testing. For CHIP members with elevated blood lead levels ≥3.5 mcg/dL: Complete AET Environmental Lead Investigation Referral Form and submit to AET via fax (610.891.0559) or email (m.mcerlean@aetinc.us).