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Unlisted Procedure Code Form

Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jul 1, 2021
We identified it
Jun 19, 2026
Days to comply

Summary

BCBSRI now requires submission of a specific Unlisted Procedure Code Form along with complete medical records when filing claims for any unlisted procedure codes. Separate forms are available for physicians and facilities through the provider portal.

Action Required

Action needed
Immediately: Billing team must download and use the appropriate Unlisted Procedure Code Form from the BCBSRI provider portal when submitting claims for any unlisted procedure codes. Attach complete medical records with each submission. Update workflow to require form completion before claim submission to prevent denials.