CommercialBilling CodesLow impact
11.08.15ae, Reconstructive Breast Surgery and Post-Mastectomy Prostheses
Independence Blue Cross·Plastic Surgery, General Surgery, Oncology·Medical Policy
Effective date
Oct 1, 2026
We identified it
Sep 9, 2026
Summary
Independence Blue Cross updated HCPCS codes L8030, L8031, and L8035 for breast prostheses to include 'any type' language effective October 1, 2026. This is a coding description update only; no coverage or benefit changes were made. Billing teams must update system records and encounter forms to reflect the revised code descriptions for post-mastectomy prosthetic devices.
Action Required
By September 15, 2026: Billing team must update all billing system records, encounter forms, and reference materials to reflect the revised HCPCS code descriptions for L8030, L8031, and L8035. Specifically, update from 'silicone or equal' to 'silicone or equal, any type' and 'molded to patient model' to 'molded to patient model, any type.' Notify providers of the descriptor changes. No clinical coverage changes are required; this is a coding terminology update only. Failure to update descriptions may cause claim submission delays if manual review is triggered.