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Medicare AdvantagePrior AuthMedium impact

Molecular Markers in Fine Needle Aspirates of the Thyroid

Blue Cross Blue Shield of Rhode Island·RI · Endocrinology, Pathology, General Surgery +1 more·Physician / Facility
Effective date
Jun 1, 2020
We identified it
Jun 19, 2026
Days to comply

Summary

Effective June 1, 2020, BlueCross BlueShield of Rhode Island requires prior authorization for CPT code 81445 (molecular markers in thyroid fine needle aspirates) for BlueCHiP Medicare plans and recommends it for commercial products. This affects genetic testing procedures for thyroid nodules.

Action Required

Action needed
By June 1, 2020: Billing team must update system to require prior authorization for CPT 81445 when billing BlueCHiP Medicare plans. Update encounter forms and notify providers that prior auth is recommended for commercial plans. Claims without prior authorization may be denied for Medicare patients.

Affected Billing Codes

81445