We're working to fix a chemotherapy clinical edit error

A clinical edit for chemotherapy administration, active since June 28, 2022, has been incorrectly denying the following services across all product lines when it shouldn’t:

  • CPT codes 96401-96450, 96542-96549, 0708T, 0709T when billed with either
  • Z51.11 (encounter for antineoplastic chemotherapy) or Z51.12 (encounter for antineoplastic immunotherapy) as the primary diagnosis

We’re working diligently to fix this issue.

There’s no need to resubmit impacted claims. We’ll automatically reprocess them once the issue is resolved.