CommercialBilling CodesHigh impact
Coding and Claim Filing Requirements for Drugs
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jul 1, 2022
We identified it
Jun 19, 2026
Summary
BCBSRI now requires all drug claims to include both a valid HCPCS/CPT code AND an appropriate National Drug Code (NDC). Pricing will be determined by the HCPCS/CPT code and its unit of measure.
Action Required
Before July 1, 2022: Billing team must update billing software to require both HCPCS/CPT codes AND National Drug Codes (NDC) for all drug claims submitted to BCBSRI. Update encounter forms and EMR templates to capture NDC information. Train staff on dual coding requirements. Claims missing either code will be rejected.