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Reminder: Network Participation Agreement (NPA) requires practices to update CLIA Certificate with BCBSNC

Blue Cross and Blue Shield of North Carolina (BCBSNC) would like to take this opportunity to remind providers that have signed a Network Participation Agreement (NPA), payment for in-office laboratory service fees will be limited to those services for which your practice has provided BCBSNC with evidence of CLIA certification-exception would be for services identified by Medicare as Clinical Laboratory Improvement Amendment (CLIA) excluded or CLIA waiver.

BCBSNC considers this reminder necessary as there has been a recent increase in providers experiencing limited payment due to failure to provide an updated copy of their CLIA certificate. Remember, BCBSNC must be provided with evidence of CLIA certification "prior" to receipt of the claim for in-office labs performed in your office.

The most up-to-date Clinical Laboratory Improvement Amendments (CLIA) service codes by category can be obtained by visiting the CMS Web site at: www.cms.hhs.gov/CLIA/10_Categorization_of_Tests.asp.