Medicare AdvantagePrior AuthHigh impact
Spine surgery codes will require authorization through eviCore starting February 1st
Blue Cross Blue Shield of Rhode Island·RI · Orthopedics, Neurosurgery·Physician / Facility
Effective date
Feb 1, 2023
We identified it
Jun 19, 2026
Summary
Starting February 1, 2023, BCBSRI Medicare Advantage members will require prior authorization through eviCore for all spine surgery procedures. This expands eviCore's existing authorization management beyond radiology and cardiology to include spine surgeries.
Action Required
Before February 1, 2023: Billing and clinical staff must register for eviCore training webinars in January to learn the new authorization process. Update workflow procedures to obtain eviCore prior authorization for all spine surgery procedures on BCBSRI Medicare Advantage patients. Download the new 'Prior Authorization of spine surgery effective February 1, 2023' policy from the provider portal when available. Claims will be denied without proper eviCore authorization.