Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
Blue Cross Blue Shield of Rhode IslandMedicare Advantage · Billing Codes · Physician / Facility · RI · ENT (Ear, Nose & Throat), Orthopedics, Gastroenterology +4 moreHigh impact

CPT code changes

Act
immediately
Effective date
Jan 1, 2023
Identified
Jun 19, 2026

Summary

Blue Cross Blue Shield of Rhode Island updated CPT code coverage rules effective January 1, 2023, with specific changes affecting reimbursement, medical necessity requirements, and prior authorization for dozens of codes across multiple specialties. One code (0359U) has a delayed effective date of March 1, 2023.

Get alerts when payers change rules like this one

We check Blue Cross Blue Shield of Rhode Island and other payers every day and email you when a change matches your specialty and state.

Get Blue Cross Blue Shield of Rhode Island alertsPolicy Monitoring is free. No card required.

What to do

immediately · 4 steps
01Billing team must update claims processing system with new CPT code coverage rules - mark specified codes as not covered, not medically necessary, or not separately reimbursed based on plan type.
02Update prior authorization requirements for medical review codes including 43291, 69728, 81418, 81441, 81449, 81451, 81456, 0742T.
03By March 1, 2023: Add prior authorization requirement for code 0359U.
04Notify patients of non-covered services before rendering care to avoid billing issues.

Codes mentioned

4329098978228609206690678697296973015853158544329169728814188144181449814518145630469

Original notice

CPT code changes
bcbsri.com · Always check the source before changing claims.
View original ↗

Related changes

See all Blue Cross Blue Shield of Rhode Island changes →
Policy updatesHighEffective Aug 1, 2023 · Physician / FacilityPolicy updatesHighEffective Jun 1, 2023 · Provider UpdateMedical policy updatesHighEffective Aug 1, 2025 · Physician / FacilityMedical policy updatesHighEffective Oct 1, 2025 · Physician / FacilityBrowse every Blue Cross Blue Shield of Rhode Island change in the policy list

Related policy hubs

Blue Cross Blue Shield of Rhode Island policiesRI policy changesENT (Ear, Nose & Throat)OrthopedicsGastroenterologyOphthalmologyPathologyPlastic SurgeryGeneral SurgeryCode 43290Code 98978Code 22860Code 92066Code 90678Code 69729Code 69730Code 15853Code 15854Code 43291Code 69728Code 81418Code 81441Code 81449Code 81451Code 81456Code 30469

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account