CommercialBilling CodesMedium impact
00.01.52ac, Bundled Procedure Codes
Independence Blue Cross·Family Medicine, Internal Medicine, OB-GYN +1 more·Medical Policy
Effective date
Oct 1, 2026
We identified it
Jul 2, 2026
Summary
Independence Blue Cross updated policy 00.01.52ac to clarify that CPT 99459 (E/M with pelvic exam) is not eligible for separate reimbursement and cannot be billed to members. Additionally, six HCPCS codes (G2061, G2062, G2063, G9037, G9038, Q0239) have been terminated and removed from the non-reimbursable services list, effective October 1, 2026.
Action Required
By September 15, 2026: Billing team must update billing system rules to prevent separate reimbursement claims for CPT 99459 when billed with E/M services. Remove CPT 99459 from billable codes on encounter forms and patient statements. Update provider education materials to clarify that pelvic exams performed during E/M visits (CPT 99459) are bundled and cannot be billed separately or to patients. Remove the six terminated HCPCS codes (G2061, G2062, G2063, G9037, G9038, Q0239) from the practice's non-covered service list, as these codes are no longer restricted under this policy. Train all billing and clinical staff on the change before the October 1, 2026 effective date. Failure to comply will result in claim denials and patient balance issues for practices that bill these codes separately.