C7542 Insurance Policy Changes

HCPCS C7542 is officially defined as "Endoscopic retrograde cholangiopancreatography (ercp) with biopsy, single or multiple, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s)." HCPCS C7542 is referenced in 6 tracked payer policy changes from Independence Blue Cross. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS C7542 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.