CommercialAdministrativeMedium impact
Radiology components reminder
Blue Cross Blue Shield of Rhode Island·RI · Radiology, Orthopedics·Physician / Facility
Effective date
Mar 1, 2020
We identified it
Jun 19, 2026
Summary
When the same radiology procedure is performed multiple times on the same day by different providers/facilities, the second claim will be denied and must be appealed with documentation proving the member was seen at your facility. This affects any practice that performs radiology services when patients may have received the same exam elsewhere on the same day.
Action Required
Immediately: Billing team must implement a process to identify when radiology claims are denied for duplicate same-day procedures. When this occurs, appeal the denial with documentation proving the member was seen at your facility (appointment records, visit notes, facility logs). Train staff to ask patients about any radiology procedures performed elsewhere on the same day to proactively identify potential duplicates.