CommercialDocumentationMedium impact
Hints for HEDIS® (and more)
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +2 more·Physician
Effective date
Sep 1, 2020
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island has released updated HEDIS quality improvement guidance focusing on breast cancer screening for women ages 50-74. This policy provides billing teams with specific CPT codes and documentation requirements to properly close care gaps and ensure compliant mammography claims processing.
Action Required
Billing team should review mammography claims to ensure proper documentation and coding. Use CPT Category II code 3014F for screening mammography when documented. Ensure all mammography screenings in medical records include specific date and result. Verify claims are submitted from the radiology facility where mammogram was performed. Update encounter forms to remind providers to document breast cancer screening discussions and annual history reviews.