Updates were made that impact HCPCS codes J1748, J8611, J8612, Q5137. Please refer to details below....

We have completed our review of the July 2024 CPT code changes, including any category II performanc...

Emergency Department (ED) Outpatient Facility Evaluation and Management (E/M) Coding PolicyAs part o...

Effective September 1, 2024, prior authorization will be removed from 95805: Multiple sleep latency ...

The following policies were recently reviewed for annual update. The full texts of these policies ar...

BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...

G2211 will be considered NSR effective July 1, 2024Effective July 1, 2024, CPT G2211 code will be NS...

Minimal Residual Disease Testing for CancerEffective August 1, 2024, the medical criteria used to de...

The following policies were recently reviewed for annual update. The full texts of these policies ar...

BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...

G2211 will be considered NSR effective July 1, 2024Effective July 1, 2024, CPT G2211 code will be NS...

Prior Authorization via Web-Based Tool for Durable Medical Equipment (DME)Effective July 1, 2024, HC...

The following policies were recently reviewed for annual update. The full texts of these policies ar...

The following new policy was recently created:Fractional Carbon Dioxide (CO2) Laser Ablation Treatme...

BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...

The following new policies were recently created:Axillary Reverse Mapping for the Prevention of Brea...

The following policies were recently reviewed for annual update. The full texts of these policies ar...

Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms Effective June 1, 2024, C...

We have completed our review of the April 2024 CPT code changes, including any category II performan...

We have completed our review of the April 2024 Healthcare Common Procedure Coding System (HCPCS) cha...

BCBSRI must follow CMS guidelines for national coverage determinations (NCDs) or local coverage dete...

IQ criteria updatesEffective May 1, 2024 – IQ criteria updates to the CP:Procedures Reduction Mammop...

The following policies were recently reviewed for annual update. The full texts of these policies ar...

The following new policy was recently created:Suture Button Suspensionplasty Fixation System for Thu...