Medicare AdvantageAdministrativeMedium impact
Hints for HEDIS® (and more)
Blue Cross Blue Shield of Rhode Island·RI · Orthopedics, Family Medicine, Internal Medicine +2 more·Physician
We identified it
Jun 19, 2026
Summary
BCBSRI has updated their HEDIS quality measure guidance for osteoporosis management in women who had fractures (OMW). This affects Medicare Advantage members ages 67-85 who had fractures, requiring bone mineral density tests or osteoporosis medication prescriptions within 6 months of fracture to close care gaps.
Action Required
Billing team must ensure proper coding for bone mineral density tests using CPT codes 76977, 77078, 77080, 77081, 77082, 77085, 77086 for women ages 67-85 with fractures. Contact Quest HealthConnect at 1-884-943-8435 for in-home heel scans. Contact Quality Concierge Team at QualityHEDIS@bcbsri.org or (401) 459-1005 for HEDIS support and gap closure assistance.