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12.01.01bu, Experimental/Investigational Services
Effective date
Jul 1, 2026
Identified
Jul 28, 2026
Summary
Independence Blue Cross updated its Experimental/Investigational Services policy effective 07/01/2026, adding 30 new CPT codes, 3 new HCPCS codes, and 2 unlisted service categories (VersaWrap and Stravix Nerve Wrap) to the non-covered list. Additionally, 5 CPT codes, 3 HCPCS codes were removed as now eligible for coverage, and 1 CPT code was terminated. Billing teams must update their denial rules and billing software to reflect these changes immediately.
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What to do
Action · 5 steps
01By 06/30/2026: Billing team must update billing system denial rules to reject all claims containing the 30 newly added CPT codes (0636U, 0637U, 0638U, 0639U, 0640U, 0654U, 0655U, 0656U, 1026T-1042T, 1050T-1053T), 3 new HCPCS codes (C1609, C8014, G0577), and unlisted codes 64999, A4649, C9399 when submitted for VersaWrap scar barrier membrane or Stravix Nerve Wrap applications.
02Remove CPT codes 55880, 64466, 64467, 64468, 64469, and HCPCS codes C1747, L2006, and L2221 from the experimental/investigational non-covered list and update system to allow coverage as eligible services.
03Remove terminated CPT code 0577U from all billing edits.
04Update CPT code descriptions for 0522U, 0598U, 0882T, 0883T, and C9809 in billing software to reflect revised narratives.
05Configure system to automatically deny claims for experimental/investigational codes without manual review.
If missed: Failure to update billing rules will result in improper payment of non-covered services and potential recovery audits by Independence Blue Cross.
Codes mentioned
C1609C8014G057764999A4649C93995588064466644676446864469C1747L2006L2221C9809
Original notice
12.01.01bu, Experimental/Investigational Services
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
See all Independence Blue Cross changes →MA00.005at, Experimental/Investigational ServicesHighEffective Jul 1, 2026 · Medical PolicyMA03.003p, Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other ServiceMediumEffective Jan 1, 2025 · Coding03.00.06ab, Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other ServiceMediumEffective Jan 1, 2025 · Coding12.01.01bv, Experimental/Investigational ServicesMediumEffective Oct 1, 2026 · Medical PolicyBrowse every Independence Blue Cross change in the policy list