CommercialCoverageMedium impact
MHK Updates
Blue Cross Blue Shield of Rhode Island·RI · Orthopedics, Neurosurgery, Oncology +1 more·Physician / Facility
Effective date
Jun 1, 2023
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island is implementing updates to their MHK (Medical Health Knowledge) system effective June 1, 2023, affecting coverage policies for spinal decompression/fusion procedures and several molecular diagnostic tests including genetic testing for chronic myeloid leukemia, cystic fibrosis, hereditary thrombophilia, and spinal muscular atrophy.
Action Required
By June 1, 2023: Billing team must review updated MHK coverage policies for spinal decompression/fusion procedures (cervical, lumbar, thoracic) and molecular diagnostic tests (BCR::ABL1, CFTR, hereditary thrombophilia, SMA testing). Verify current prior authorization requirements and coverage criteria in BCBS RI system for these procedure categories and update billing workflows accordingly.