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Hints for HEDIS® (and more)
Act
immediately
Effective date
Aug 1, 2020
Identified
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.
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What to do
immediately · 3 steps
01Billing team should submit CPT Category II code 3072F for diabetic patients with negative retinopathy based on prior year exams.
02Review diabetic patient panels to ensure A1c, microalbumin screening, and eye exam orders are scheduled.
03Submit appropriate CPT Category II codes for blood pressure readings from in-office visits to support HEDIS quality reporting.
Original notice
Hints for HEDIS® (and more)
bcbsri.com · Always check the source before changing claims.
Related changes
See all Blue Cross Blue Shield of Rhode Island changes →September 2017MediumNo effective date · Provider UpdateCPT Category II CodesMediumNo effective date · PhysicianHints for HEDIS® (and more)LowEffective Jan 1, 2019 · PhysicianHints for HEDIS® (and more)MediumEffective Feb 1, 2019 · PhysicianBrowse every Blue Cross Blue Shield of Rhode Island change in the policy list