Medicare AdvantagePrior AuthMedium impact
Additional CPT and HCPCS Level II code changes
Blue Cross Blue Shield of Rhode Island·RI · Oncology·Physician / Facility
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield of Rhode Island updated CPT and HCPCS code coverage designations effective July 1, 2019. Multiple codes now require medical review or preauthorization, while others are not separately reimbursed or not medically necessary.
Action Required
Billing team must update system settings for BCBS Rhode Island: Obtain preauthorization before providing services with codes 0550T, J9356, Q5112-Q5115, C9049, C9050, C9052 for commercial products. Do not bill codes 0559T, 0560T, 0561T, 0562T, C9756 separately as they are bundled. Mark codes 0543T-0558T and 0084U-0104U as requiring medical review for BlueCHiP Medicare and not medically necessary for commercial products.