Medicare AdvantageBilling CodesMedium impact
MA00.030al, Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
Independence Blue Cross·Pathology·Medical Policy
Effective date
Jul 1, 2026
We identified it
Aug 6, 2026
Summary
Independence Blue Cross updated MA00.030al laboratory services policy effective 07/01/2026 with CPT/HCPCS code changes. Four CPT codes (0029U, 0032U, 0423U, 0577U) were terminated from the capitated laboratory list, one CPT code (87638) was added, and two codes (0034U, 0598U) underwent narrative revisions. Billing teams must update systems to reflect these code changes to avoid claim denials for HMO/HMO-POS members.
Action Required
By July 1, 2026: Billing team must update billing system to remove CPT codes 0029U, 0032U, 0423U, and 0577U from the capitated laboratory services list in Attachment A1. Add CPT code 87638 to the capitated laboratory services list. Review and update any internal documentation or billing rules for CPT codes 0034U and 0598U to reflect their narrative revisions. Notify laboratory partners and PCP designated capitated sites of these changes. Failure to update codes may result in incorrect claim routing and denials for Independence Blue Cross Medicare Advantage HMO/HMO-POS members.