CommercialBilling CodesMedium impact
00.01.52ac, Bundled Procedure Codes
Independence Blue Cross·Family Medicine, Internal Medicine, OB-GYN +1 more·Medical Policy
Effective date
Oct 1, 2026
We identified it
Oct 2, 2026
Summary
Independence Blue Cross has updated policy 00.01.52ac effective 10/01/2026 to clarify that pelvic exams performed during E/M visits (CPT 99459) are not eligible for separate reimbursement. Additionally, six HCPCS codes (G2061, G2062, G2063, G9037, G9038, Q0239) have been terminated and removed from the bundled services list.
Action Required
By 10/01/2026: Billing team must update billing system and claim scrubbing rules to prevent separate billing of CPT 99459 when submitted with E/M services. Review and remove bundling rules for terminated HCPCS codes G2061, G2062, G2063, G9037, G9038, and Q0239 from claim submission edits. Notify providers that pelvic exams included in E/M encounters cannot be billed separately and members cannot be balance-billed for these services. Update encounter forms and fee schedules to reflect that CPT 99459 is not eligible for separate reimbursement consideration. Failure to comply will result in claim denials and potential overpayment recovery.