All PlansAdministrativeHigh impact
New Payment Policy: Device Intensive Procedure Edit
Blue Cross Blue Shield of Rhode Island·RI · Orthopedics, Cardiology, Neurosurgery +4 more·Facility
Effective date
Aug 15, 2026
We identified it
Jun 19, 2026
Summary
Starting August 15, 2026, outpatient facility claims for device intensive procedures must include a corresponding device procedure code on the same claim for the same date of service, or the claim will be denied. This policy only applies to facility claims (UB-04 forms, bill types 13X or 76X) and does not affect physician office billing.
Action Required
By August 15, 2026: Facility billing team must update billing system to require corresponding device procedure codes when billing for device intensive procedures on outpatient facility claims (UB-04, bill types 13X or 76X). Create billing edits to ensure device codes are included on the same claim for the same date of service. Train staff to use appropriate modifiers for reduced, discontinued, or terminated procedures. Claims without corresponding device codes will be denied.