Medicare AdvantageBilling CodesHigh impact
MA00.026ab, Bundled Procedure Codes
Independence Blue Cross·OB-GYN, Family Medicine, Internal Medicine +1 more·Medical Policy
Effective date
Oct 1, 2026
We identified it
Oct 2, 2026
Summary
Independence Blue Cross Medicare Advantage is revising bundling policies effective 10/01/2026. CPT code 99459 (pelvic exam during E/M) is now classified as not eligible for separate reimbursement and has been added to Attachment B. HCPCS codes G9037 and G9038 have been terminated and removed from Attachment C. Billing teams must stop billing these codes separately and ensure providers understand they cannot bill members for these services.
Action Required
By 10/01/2026: Billing team must update claim submission rules in billing software to prevent separate reimbursement billing for CPT 99459. Ensure CPT 99459 is bundled into E/M reimbursement when billed on the same date by the same provider for the same member. Remove G9037 and G9038 from all active billing code lists and templates. Communicate to all participating providers that CPT 99459 cannot be billed separately and members cannot be balance-billed for this service. Update encounter forms and provider education materials to reflect that pelvic exams performed during 99459 E/M visits are included in the E/M reimbursement. Failure to comply will result in claim denials and potential compliance issues for participating providers.