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Independence Blue CrossMedicare Advantage · Billing Codes · Medical Policy · Orthopedics, Physical Therapy, Occupational Therapy +1 moreMedium impact

MA05.057f, Upper-Limb Prostheses

Effective date
Apr 1, 2026
Identified
Oct 29, 2026

Summary

Independence Blue Cross Medicare Advantage reissued policy MA05.057f on 10/28/2026 to communicate its continuing position on upper-limb prostheses coverage. The policy was previously updated on 04/01/2026 with HCPCS code changes: L7499 was added, L6000, L6010, and L6020 were deleted, and L6028 was revised. Coverage criteria for passive, body-powered, and externally powered prostheses remain unchanged and apply to Medicare Advantage members.

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What to do

Action · 7 steps
01Already effective 04/01/2026: Verify that the practice has implemented the HCPCS code changes in its billing system and claims submission processes.
02Confirm current applicability by.
03Billing team should ensure L7499 is active in the system for upper extremity prosthetic devices not otherwise specified.
04Billing team should verify that L6000, L6010, and L6020 have been removed from active coding lists and replaced with appropriate alternatives where applicable.
05Billing team should confirm that L6028 coding reflects the revised definition for partial hand, finger, and thumb prosthesis at metacarpal level.
06Clinical staff should continue applying the unchanged medical necessity criteria (comprehensive evaluation by licensed provider and prosthetist, functional evaluation for myoelectric devices, etc.) when supporting prosthesis claims for Independence Blue Cross Medicare Advantage members.
07The 10/28/2026 reissuance is administrative and does not change coverage criteria.

Codes mentioned

L7499L6000L6010L6020L6028

Original notice

MA05.057f, Upper-Limb Prostheses
medpolicy.ibx.com · Always check the source before changing claims.
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Related changes

See all Independence Blue Cross changes →
05.00.72j, Upper Limb ProsthesesMediumEffective Oct 28, 2026 · Medical PolicyMA05.057f, Upper-Limb ProsthesesMediumEffective Apr 1, 2026 · Medical Policy05.00.72j, Upper Limb ProsthesesMediumEffective Apr 1, 2026 · Medical PolicyMA00.010aw, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative ServicesHighEffective Apr 1, 2026 · NetworkBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesOrthopedicsPhysical TherapyOccupational TherapyPM&R (Physical Medicine & Rehab)Code L7499Code L6000Code L6010Code L6020Code L6028

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