Medicare AdvantageCoverageMedium impact
Medical policy updates
Blue Cross Blue Shield of Rhode Island·RI · Cardiology, Gastroenterology, Orthopedics +2 more·Physician / Facility
Effective date
Dec 1, 2024
We identified it
Jun 19, 2026
Summary
Multiple medical policy updates effective December 1, 2024, including coverage changes for cardiovascular biomarker testing (CPT 82610 now covered when filed with appropriate ICD-10 codes), additional covered ICD-10 codes for Vitamin D testing in IBD patients, and prior authorization changes for progressive scoliosis and solid tumor genetic testing procedures.
Action Required
By December 1, 2024: Billing team must update system coverage rules for CPT 82610 (now covered for Medicare Advantage and Commercial with appropriate ICD-10 codes), add new covered ICD-10 codes for Crohn's Disease and Ulcerative Colitis to CPT 82306, update CPTs 0656T and 0657T to not covered for Medicare Advantage (remove prior auth requirement), and ensure CPTs 0391U and 0334U require prior authorization using Next Generation Sequencing criteria. Update encounter forms and notify providers of coverage changes.