Medicare AdvantagePrior AuthHigh impact
Updated Policies (outside of Annual review)
Blue Cross Blue Shield of Rhode Island·RI · Dermatology, Oncology, Urology +6 more·Physician / Facility
Effective date
Aug 1, 2022
We identified it
Jun 19, 2026
Summary
BCBS RI updated multiple medical policies effective August 1, 2022, with significant changes including new prior authorization requirements for several procedures, coverage expansions for corneal cross-linking and hypoglossal nerve stimulation, and addition of new billing codes across various specialties.
Action Required
By August 1, 2022: Billing team must update systems to require prior authorization for CPT codes 55880, 64582, and 64583 for Medicare Advantage plans, and codes 64582 and 64583 for commercial plans. Add new codes A2001, E2102, A4238, A9595, 87913, 91309, and 0094A to billing systems. Update encounter forms to reflect corneal collagen cross-linking (0402T) now requires prior auth for both plan types. Configure web-based prior authorization tool for affected procedures. Claims without proper authorization will be denied.