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CommercialBilling CodesMedium impact

Policy Updates

Blue Cross Blue Shield of Rhode Island·RI · Neurology, PM&R (Physical Medicine & Rehab), Physical Therapy +4 more·Physician / Facility
Effective date
Nov 1, 2022
We identified it
Jun 19, 2026
Days to comply

Summary

BCBS Rhode Island has updated multiple policies effective November 1, 2022, including new CPT codes for low-level laser therapy, updated lymphedema treatment criteria, expanded Duchenne muscular dystrophy drug coverage, and new tick-borne encephalitis and hepatitis B vaccine codes. Medicare Advantage preventive services have also been updated with new low dose CT scan criteria.

Action Required

Action needed
By November 1, 2022: Billing team must update billing software to include new vaccine CPT codes 90626, 90627, and 90759. Review and implement updated medical necessity criteria for low-level laser therapy, lymphedema treatments, and Duchenne muscular dystrophy medications. Update Medicare Advantage preventive service protocols for low dose CT scans with revised age and smoking history criteria. Reference full policy details via provided links for complete coding and coverage updates.

Affected Billing Codes

90626
90627
90759