Medicare AdvantageCoverageMedium impact
Medical policy updates
Blue Cross Blue Shield of Rhode Island·RI · Diagnostic Imaging, Oncology, Cardiology·Physician / Facility
Effective date
May 1, 2025
We identified it
Jun 19, 2026
Summary
BCBSRI has updated medical policies effective May 1 and June 1, 2025, affecting prior authorization requirements for durable medical equipment, expanding covered diagnosis codes for CA-125 testing and cardiovascular biomarker testing, and adding new requirements for human leukocyte antigen testing with mandatory modifier usage.
Action Required
By May 1, 2025: Update billing system to include new covered ICD-10 codes E10.A0-E10.A2, E88.810, E88.82 for CPT codes 83700, 83701, 83704 and codes T45.AX1A-T45.AX5S, Z92.26 for CPT 82610. By June 1, 2025: Configure system to use web-based authorization tool for HCPCS E2513, add ICD-10 codes R19.01-R19.04 as covered for CPT 86304, and ensure Modifier 32 is automatically applied to CPT codes 81370-81383 and 86812, 86817, 86821, 86825, 86826, 86829-86835 for Rhode Island HLA testing mandate.