CPT 90993 is referenced in 2 tracked payer policy changes from Blue Cross of Idaho. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 90993 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Blue Cross of Idaho has revised PAP420 to add new Revenue and HCPCS codes for dialysis billing, effective October 2026. The policy clarifies accepted CPT/Revenue code combinations for dialysis modalities on UB-04 claims and requires compliance with current Medicare claims submission guidelines. Billing teams must verify the specific new codes added and update billing systems accordingly.
Blue Cross of Idaho updated PAP422 in January 2024 to clarify that out-of-network (OON) dialysis claims processed through the Gemstone claims system will be paid directly to the provider, whereas Legacy system claims are paid to the member. This change affects claim payment routing for non-contracting dialysis facilities and requires billing teams to understand which claims system processes their claims to direct reimbursement appropriately.
Watch 90993
Get one email when a payer policy names 90993, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.
See every payer rule for 90993
Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 90993 in one place.
Get alerts for changes like this
Save a search and get email alerts when a new policy change matches your filters: daily or weekly, your choice, on every plan.