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CommercialCoverageMedium impact

Allergy Testing

Blue Cross Blue Shield of Rhode Island·RI · Allergy & Immunology, Family Medicine, Internal Medicine +1 more·Physician / Facility
Effective date
Aug 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Effective August 1, 2019, BCBSRI will only consider CPT codes 86003 and 86008 for allergy testing medically necessary when billed with specific ICD-10 diagnosis codes for Commercial members only. Claims submitted without the approved diagnosis codes will likely be denied.

Action Required

Action needed
By August 1, 2019: Billing team must verify that CPT codes 86003 and 86008 for allergy testing are only billed with approved ICD-10 diagnosis codes for BCBSRI Commercial members. Update billing system edits to flag these combinations and review the full policy text for the complete list of acceptable diagnosis codes. Claims with non-approved diagnosis codes will be denied.

Affected Billing Codes

86003
86008