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Radiology Billing Changes: HEDIS LBP Impact

Florida Blue·FL · Radiology, Diagnostic Imaging·Claims & Billing
Effective date
Not stated
We identified it
Jun 16, 2026
Days to comply
—

Summary

Florida Blue updated HEDIS specifications for low back pain imaging studies, requiring radiology providers to include ALL relevant ICD-10 codes from referrals, including exclusion codes like trauma history, to ensure accurate patient inclusion/exclusion in quality measures.

Action Required

Action needed
Immediately: Billing team must update radiology claim submission process to capture and submit ALL ICD-10 codes from low back pain imaging referrals, including exclusion codes (e.g., trauma codes like G89.11 alongside low back pain codes like M54.5). Review current LBP imaging claims to ensure complete code submission. Contact HEDISInnovations@BCBSFL.com with questions.

Affected Billing Codes

G89.11
M54.5

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