Medicare AdvantagePrior AuthMedium impact
CPT code changes
Blue Cross Blue Shield of Rhode Island·RI · Diagnostic Imaging, Pathology·Physician / Facility
Effective date
Apr 1, 2022
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Rhode Island has implemented April 2022 CPT code changes effective April 1, 2022. Multiple new PLA codes (0306U-0322U) are subject to medical review for Medicare Advantage plans and are deemed not medically necessary for Commercial products.
Action Required
Immediately: Billing team must update system to flag codes 0306U-0322U for prior authorization when billing Medicare Advantage plans. Configure system to deny these codes for Commercial products as they are not medically necessary. Update encounter forms and notify providers that these PLA codes require preauthorization for BlueCHiP Medicare and are not covered for Commercial products.