Medicare AdvantagePrior AuthHigh impact
Policy updates
Blue Cross Blue Shield of Rhode Island·RI · Endocrinology, Neurosurgery, Orthopedics +2 more·Physician / Facility
Effective date
Jan 1, 2023
We identified it
Jun 19, 2026
Summary
Multiple policy changes affecting various specialties, with the most significant being new prior authorization requirements for implantable device removal codes (61880, 61888) and arthroscopy procedures (29827, 29881) starting February 1, 2023. Continuous glucose monitors for Medicare Advantage now require prior auth via web-based tool starting January 1, 2023.
Action Required
By January 1, 2023: Update billing system to require prior authorization via web-based tool for implantable continuous glucose monitors (I-CGM) for Medicare Advantage plans only. By February 1, 2023: Billing team must configure prior authorization requirements for CPT codes 61880, 61888 (implantable device removal), 29827 (shoulder arthroscopy), and 29881 (knee arthroscopy). Update encounter forms and EMR alerts to remind providers. Stop billing CPT 0693T under spinal visualization policy - move to New Technology policy. Configure Pluvicto (A9607) requests to route through Prime drug management vendor instead of BCBSRI. Claims without proper prior authorization will be denied.