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

MHK UpdatesEffective November 1, 2024, IQ criteria updates to the CP:Procedures Transcatheter Aortic...

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

The following new policies have been created. The effective dates may vary so please review the full...

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

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

CMS released a new code J0175 effective July 2nd, 2024. These updates will be added to our claims pr...

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

MHK authorization updateEffective October 1, 2024, prior authorization criteria for Water Vapor Ther...

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

The following new policies have been created. Effective dates vary so please review the full text of...

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

Revisions have been made for three (3) of the July 2024 current procedural terminology (CPT) Categor...

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...