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Unlisted Procedure Code Form

Blue Cross Blue Shield of Rhode Island·RI·Provider Update
Effective date
May 1, 2021
We identified it
Jun 19, 2026
Days to comply

Summary

BCBS Rhode Island requires providers to submit a specific Unlisted Procedure Code Form along with complete medical records when filing claims for unlisted procedure codes. This is a reminder of an existing requirement, with separate forms available for facilities and physicians on the provider portal.

Action Required

Action needed
Immediately: Billing team must ensure the appropriate Unlisted Procedure Code Form (facility or physician version) is submitted with complete medical records for all unlisted procedure code claims. Download forms from BCBS RI provider portal or use provided links. Claims for unlisted codes without proper forms may be delayed or denied.