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Hints for HEDIS® (and more)
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, Endocrinology +2 more·Physician
Effective date
Aug 1, 2020
We identified it
Jun 19, 2026
Summary
BCBSRI has updated guidance for HEDIS quality measure reporting and gap closure following COVID-19 disruptions. The policy provides specific recommendations for breast cancer screening, colorectal cancer screening, diabetes management, and blood pressure control, including proper CPT Category II code reporting.
Action Required
Immediately: Billing team should submit CPT Category II code 3072F for diabetic patients with negative retinopathy based on prior year exams. Review diabetic patient panels to ensure A1c, microalbumin screening, and eye exam orders are scheduled. Submit appropriate CPT Category II codes for blood pressure readings from in-office visits to support HEDIS quality reporting.