Medicare AdvantagePrior AuthHigh impact
Policy updates
Blue Cross Blue Shield of Rhode Island·RI · Neurosurgery, Orthopedics, Oncology +4 more·Physician / Facility
Effective date
Mar 1, 2023
We identified it
Jun 19, 2026
Summary
Multiple policy updates effective March 1, 2023, including new prior authorization requirements for spinal procedures (CPT 63661, 63662, 63688), tumor treating field therapy devices (HCPCS E0766), and various coding updates for allergy testing, genetic testing, and other specialties. Several policies are transitioning to web-based authorization tools with different criteria for Medicare Advantage versus commercial plans.
Action Required
By March 1, 2023: Billing team must update system to require prior authorization for CPT codes 63661, 63662, and 63688 (spinal procedures) and HCPCS code E0766 (tumor treating field therapy). Update ICD-10 codes for allergy testing - replace T40.7X5A/D/S with T40.715A/D/S. Configure system to use web-based authorization tool for these codes with different criteria for Medicare Advantage vs commercial plans. Update encounter forms and train staff on new prior auth requirements. Claims will be denied without proper authorization.