Summary
BCBSRI has updated multiple medical policies with new criteria, coding changes, and coverage modifications effective at various dates from August 2022 through January 2023. Key changes include new requirements for joint replacement surgery, radiation therapy updates, DME prior authorization changes, and COVID-19 policy clarifications.
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What to do
by Jan 1, 2023 · 5 steps
01Billing team must update prior authorization requirements for standing frames (DME) for commercial products only.
02Review and implement new criteria for Total Joint Arthroplasty requiring diabetes control, BMI, and smoking status documentation effective December 1, 2022.
03Update billing system to reflect CPT codes 33267 and 33269 now covered under Surgical Left Atrial Appendage Occlusion policy.
04Verify ICD-10 code C84.7 is linked to CPT 86300 for tumor marker billing.
05Update telemedicine billing to include POS 10 and modifier FQ effective April 1, 2022.
Codes mentioned
3326733269863009949599496
Original notice
Policy Updates
bcbsri.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Rhode Island changes →Policy UpdatesMediumEffective Jul 1, 2019 · Provider UpdateCPT code changesHighEffective Jan 1, 2022 · Physician / FacilityFollow-up care after hospitalizationMediumEffective Apr 1, 2024 · PhysicianTransitional Care Management, Chronic Care Management, and Principal Care Management servicesMediumEffective Jan 1, 2025 · PhysicianBrowse every Blue Cross Blue Shield of Rhode Island change in the policy list