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Medicare AdvantageBilling CodesMedium impact

Policy updates

Blue Cross Blue Shield of Rhode Island·RI · Ophthalmology, Oncology, Family Medicine +2 more·Physician / Facility
Effective date
Oct 1, 2023
We identified it
Jun 19, 2026
Days to comply

Summary

BCBS Rhode Island updated multiple policies with changes to billing codes, prior authorization requirements, and coverage criteria. Key changes include new CPT codes for corticosteroid implants, removal of some consultation codes from non-reimbursable lists, and new prior auth requirements for cancer testing.

Action Required

Action needed
By October 1, 2023: Remove CPT codes 99446-99449 and 99451 from non-reimbursable lists in billing system for professional providers. By November 1, 2023: Add CPT J1096 to corticosteroid implant billing with ICD-10 diagnosis requirements, update CPT 81308 to follow policy criteria instead of web-based authorization, obtain prior authorization for Guardant REVEAL cancer testing on MA plans, and add G0176 to non-reimbursable list. By January 1, 2024: Update preventive service billing for anxiety screening and limit diabetes screening codes 82947/83036 to once per year.

Affected Billing Codes

J1096
81308
82947
83036
99446
99447
99448
99449
99451
G0176