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MA00.010aw, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Effective date
Apr 1, 2026
Identified
Aug 15, 2026
Summary
Independence Blue Cross MA00.010aw policy has been updated with CPT/HCPCS code changes effective 04/01/2026 and 07/01/2026. Three prosthetic/orthotic codes (L6000, L6010, L6020) are terminated as of 04/01/2026; four laboratory codes (0029U, 0031U, 0423U, 0577U) are terminated as of 07/01/2026; two DME codes (A4318, A4479) are added effective 04/01/2026; one radiology code (1043T) is added effective 07/01/2026; and four laboratory codes (0256U, 0580U, 0598U, 0034U) have narrative revisions. Billing teams must update systems to reflect these code additions/deletions to avoid claim denials.
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What to do
Action · 11 steps
01REQUIREMENTS:
- By 03/31/2026: Billing team must remove CPT/HCPCS codes L6000, L6010, and L6020 from all billing software, superbill templates, and fee schedules.
02Do not bill these terminated prosthetic/orthotic codes effective 04/01/2026 or claims will be denied.
03- By 06/30/2026: Billing team must remove laboratory codes 0029U, 0031U, 0423U, and 0577U from billing system and clinical templates.
04Do not bill these terminated codes effective 07/01/2026 or claims will be denied.
05- By 03/31/2026: Billing team must add DME codes A4318 and A4479 to billing software, fee schedules, and documentation.
06These codes are eligible for reimbursement effective 04/01/2026.
07- By 06/30/2026: Billing team must add radiology code 1043T to billing software and radiology fee schedule.
08This code is eligible for reimbursement effective 07/01/2026.
09- By 03/31/2026 and 06/30/2026 respectively: Billing team must review and update code narratives in billing system for laboratory codes 0256U, 0580U (04/01/2026 revision) and 0598U, 0034U (07/01/2026 revision) to reflect policy changes.
10Ensure provider education on narrative changes to support accurate billing and documentation.
11- Providers submitting claims must verify that only active, non-terminated codes are billed on CMS-1500 or 837p claim forms.
Codes mentioned
L6000L6010L6020A4318A4479
Original notice
MA00.010aw, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
medpolicy.ibx.com · Always check the source before changing claims.
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