Who is affected by this change?

This affects Blue Cross Blue Shield of Wyoming Endocrinology, Family Medicine, Internal Medicine providers in WY on Exchange plans.

Which billing codes are affected?

The following codes are affected: 83036, A02.1, R78.81, M21.42, Q66.89, J35.2, J35.01.

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ExchangeBilling CodesMedium impact

HEDIS Codes, UM Tool Updates & Coding Advice

Blue Cross Blue Shield of Wyoming·WY · Endocrinology, Family Medicine, Internal Medicine·Coding

Effective date

Not stated

We identified it

Jun 19, 2026

Days to comply

—

Summary

Blue Cross Blue Shield of Wyoming is requesting providers use specific Category II codes (3044F, 3051F, 3052F, 3046F) with HbA1c lab tests (CPT 83036) to improve HEDIS scores for On-exchange and FEP members. The policy also announces upcoming UM tool updates for fall and provides coding advice for automated claims review starting in March.

Action Required

Action needed

Immediately: When billing CPT 83036 (HbA1c lab test) for BCBS Wyoming On-exchange and FEP members, add appropriate Category II codes (3044F for <7.0%, 3051F for 7.0-7.9%, 3052F for 8.0-8.9%, 3046F for >9.0%) on same claim with $0.00 or $0.01 charge. Before March 2025: Update billing system to ensure revenue codes 0300, 0320, 0760 include required HCPCS codes and avoid mutually exclusive ICD-10 code combinations to prevent automated claim denials.

Affected Billing Codes

83036

A02.1

R78.81

M21.42

Q66.89

J35.2

J35.01

Related policy hubs

Blue Cross Blue Shield of Wyoming policies WY policy changes Endocrinology Family Medicine Internal Medicine Code 83036 Code A02.1 Code R78.81 Code M21.42 Code Q66.89 Code J35.2 Code J35.01