Medicare AdvantageCoverageMedium impact
CPT code changes
Blue Cross Blue Shield of Rhode Island·RI · Pathology·Physician / Facility
Effective date
Oct 1, 2020
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Rhode Island updated CPT code coverage rules effective October 1, 2020. Twenty new laboratory/pathology U-codes (0203U-0222U) now require medical review for Medicare plans and are deemed not medically necessary for commercial plans. Additionally, CPT 99072 is no longer separately reimbursed across all products.
Action Required
Immediately for Rhode Island BCBS patients: Update billing system to require prior authorization for U-codes 0203U through 0222U for BlueCHiP Medicare patients. Stop billing CPT 99072 separately as it is bundled into other services. Update encounter forms to alert providers that U-codes are not covered for commercial patients. Claims without proper authorization or separate billing of 99072 will be denied.