Medicare AdvantagePrior AuthMedium impact
Additional HCPCS Level II Code Change
Blue Cross Blue Shield of Rhode Island·RI·Physician
Effective date
Jul 6, 2023
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Rhode Island added new HCPCS code J0174 to their claims processing system, effective July 6, 2023. This code requires preauthorization for Commercial products (recommended) and Medicare Advantage plans (required).
Action Required
Immediately: Update billing system to flag HCPCS code J0174 for prior authorization requirements. Billing team must configure system to require preauth for Medicare Advantage plans and recommend preauth for Commercial products. Update encounter forms and EMR alerts to notify providers that J0174 requires medical review before rendering service.