Recent data show that labs are among the top providers in submitting claims with incorrect or incomplete information. Lab claims most often are denied because of incorrect contract/member numbers, missing or invalid diagnosis codes, and incorrect patient birth dates.

Since labs do not always have direct contact with their patients, they rely on physicians to provide the correct information. It is important that physicians use the lab requisition form when they refer patients or send specimens for lab testing.

Physicians can reduce the number of pended or denied lab claims by simply completing the necessary patient information on the requisition form. Forms may vary among labs, but usually the following information is requested:

• The referring physician’s BCBSF provider number
• Patient name
• Contract/member number (include alpha prefix)
• Patient date of birth
• Location of service
• Date of service
• Diagnosis code
• CPT code

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