Reimbursement for Opened but Unused Sterile Medical Supplies/Devices
This policy governs BCBSRI reimbursement rules for prepackaged sterile medical supplies or devices that have been opened but not used, affecting providers billing Medicare Advantage and Commercial Products under Blue Cross & Blue Shield of Rhode Island.
No material clinical or coverage changes in this revision.
Reimbursement Criteria
Reimbursement criteria
Reimbursement rules for opened but unused supplies/devices under Medicare Advantage and Commercial Products:
Exceptions
- Providers may bill for items that have been inserted and removed.
- Providers may bill for items where insertion was attempted but unsuccessful (for example, attempted IUD insertion unsuccessful due to insufficient cervical dilation).
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