Summary
Independence Blue Cross added face-to-face encounter and written order prior to delivery and/or prior authorization requirements to seven manual wheelchair HCPCS codes (K0002, K0003, K0004, K0005, K0006, K0007, E1161) effective 10/28/2026, aligning with Medicare Final Rule. The practice must obtain prior authorization before scheduling or billing these codes for affected members.
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What to do
Action · 7 steps
01On or Previously due 10/28/2026 (date passed; verify current applicability), the billing team must.
02Begin submitting prior authorization requests for HCPCS codes K0002, K0003, K0004, K0005, K0006, K0007, and E1161 before scheduling or delivering manual wheelchairs to Independence Blue Cross Commercial members.
03Confirm that prescribing providers document both a face-to-face encounter with the member and a written order prior to delivery.
04Update charge entry and claim submission processes to include prior authorization approval numbers for these codes.
05Notify providers and the front desk staff that manual wheelchair orders now require prior auth and must be supported by face-to-face documentation and written orders.
06Watch for Independence Blue Cross confirmation of the new prior auth process and submission requirements.
07Claims submitted for these codes without prior authorization will be denied.
Codes mentioned
K0002K0003K0004K0005K0006K0007E1161
Original notice
05.00.12l, Manual Wheelchairs
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
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