CommercialAdministrativeLow impact
09.00.36m, First-Trimester Prenatal Screening for Fetal Aneuploidy Using Fetal Ultrasound Markers
Independence Blue Cross·OB-GYN, Radiology·Medical Policy
We identified it
Jun 25, 2026
Summary
Independence Blue Cross reissued policy 09.00.36m on 06/24/2026 with no substantive changes to first-trimester prenatal screening coverage. The policy continues to cover nuchal translucency screening combined with maternal serum markers (hCG and PAPP-A) as medically necessary, while CPT codes 0124U, 0125U, and 0126U remain terminated. Billing teams should verify no workflow changes are needed, as this is a continuation of the existing coverage position.
Action Required
No immediate action required. This is a reissue with no changes. Billing team should verify that current billing workflows for CPT codes 76813, 76814, 81508, 82397, 84163, and 84702 remain unchanged and that the terminated CPT codes 0124U, 0125U, and 0126U are not being billed. Confirm that providers ordering first-trimester aneuploidy screening are using certified ultrasonographers per policy guidelines. If this practice bills for these services, audit recent claims to ensure compliance with the three-component requirement (nuchal translucency + hCG + PAPP-A) for singleton pregnancies and ensure documentation of medical necessity is maintained.