CommercialBilling CodesHigh impact
CPT® and HCPCS Level II code changes
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jan 1, 2019
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield of Rhode Island updated their coverage and payment rules for January 2019 CPT and HCPCS code changes. Multiple codes now have restrictions including not covered, not separately reimbursed, subject to medical review, or invalid status across Commercial and BlueCHiP Medicare products.
Action Required
Immediately: Billing team must update system to reflect new code restrictions - stop billing codes marked as 'not covered' or 'invalid', obtain prior authorization for codes subject to medical review starting February 1, 2019, and use alternative codes for 'not separately reimbursed' services. Update encounter forms to alert providers about non-covered services that must be disclosed to patients before rendering care.