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MA00.005at, 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 32 new CPT codes, 3 new HCPCS codes, and 2 new unlisted code services (VersaWrap and Stravix Nerve Wrap) to the non-covered list, while removing 6 CPT codes and 1 HCPCS code that are now eligible for coverage. Billing teams must update claims systems to deny claims for newly added experimental codes and allow claims for newly eligible codes.
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What to do
Action · 5 steps
01By 06/30/2026: Billing team must update claims processing system to deny all claims containing newly added experimental CPT codes (0636U, 0637U, 0638U, 0639U, 0640U, 0654U, 0655U, 0656U, 1026T-1042T, 1050T-1053T), HCPCS codes (C1609, C8014, G0577), and unlisted codes (64999, A4649, C9399) for VersaWrap and Stravix Nerve Wrap applications.
02Concurrently, update system to ALLOW coverage for previously experimental codes now deemed eligible (CPT 55880, 64466, 64467, 64468, 64469; HCPCS C1747).
03Remove CPT code 0577U from all billing edits as it is terminated effective 07/01/2026.
04Update code narratives for CPT 0522U, 0598U, 0805T, 0806T, 0882T, and 0883T in billing software to reflect policy revisions.
05Attach updated policy Attachments A, B, and C to provider communication.
If missed: Failure to implement these changes will result in incorrect claim denials for now-eligible services and potential improper payment for experimental procedures.
Codes mentioned
C1609C8014G057764999A4649C93995588064466644676446864469C1747
Original notice
MA00.005at, Experimental/Investigational Services
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
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