CommercialCoverageMedium impact
Fecal Calprotectin Testing
Blue Cross Blue Shield of Rhode Island·RI · Gastroenterology, Internal Medicine, Family Medicine·Physician / Facility
Effective date
Aug 1, 2019
We identified it
Jun 20, 2026
Summary
Effective August 1, 2019, BCBS Rhode Island updated their Fecal Calprotectin Testing policy to expand medical necessity coverage for certain clinical diagnoses. The policy now allows coverage with specific diagnostic criteria that were previously not covered.
Action Required
By August 1, 2019: Billing team should review the full policy text at the provided URL to understand which specific clinical diagnoses now qualify for medical necessity coverage. Update billing guidelines and provider documentation requirements for fecal calprotectin testing orders to ensure claims align with the expanded coverage criteria.