CommercialCoverageHigh impact
Policy updates
Blue Cross Blue Shield of Rhode Island·RI · Wound Care, General Surgery, Urology +5 more·Provider Update
Effective date
Jun 1, 2023
We identified it
Jun 19, 2026
Summary
Multiple policy updates effective June 1, 2023, including removal of coverage for electrical stimulation wound therapy for commercial plans, addition of CPT 43843 for bariatric surgery, changes to drug prior authorization codes, and coverage changes for digestive enzyme cartridges on Medicare Advantage plans.
Action Required
By June 1, 2023: Billing team must update systems to remove coverage for electrical stimulation wound therapy codes on commercial plans, add CPT 43843 to bariatric surgery coverage, update drug prior authorization requirements with new HCPCS codes (J9037 replaces C9069, Q2053 replaces C9073, J9332 replaces C9097), change CPT 0783T from prior auth to not covered for Medicare Advantage, add B4187 to covered enteral nutrition codes, move genetic testing codes 81418 and 81441 to web-based authorization tool, and flag Q0081 as 'Use Alternate Code'. Update encounter forms and billing software rules accordingly.