Medicare AdvantageBilling CodesHigh impact
Discontinuance of HCPCS Bundle Code 80050: Effective 10/01/2025
Ambetter·AZ·Medical Policy
Effective date
Oct 1, 2025
We identified it
Aug 26, 2026
Summary
Ambetter from Arizona Complete Health is discontinuing coverage under HCPCS bundled code 80050 effective 10/01/2025. The four component tests (Comprehensive Metabolic Panel, Complete Blood Count, and Thyroid Stimulating Hormone) must now be billed individually using their respective codes. All submissions of bundled code 80050 after 09/30/2025 will receive automatic denials with explanation code 46.
Action Required
By 09/30/2025: Billing team must update billing software to STOP accepting HCPCS code 80050 for Ambetter from Arizona Complete Health and replace all instances with individual component codes (80053 for Comprehensive Metabolic Panel, 85025 and 85027 for Complete Blood Count, and 84443 for Thyroid Stimulating Hormone). Update all claim templates, encounter forms, and billing rules in the system. Communicate this change to all providers and clinical staff. Beginning 10/01/2025, any claims submitted with bundled code 80050 will be automatically denied with explanation code 46 and treatment type NC, resulting in claim rejections and potential revenue loss. Verify the change is active before the effective date.