Summary
Independence Blue Cross Medicare Advantage added face-to-face encounter and written order prior authorization requirements for home oxygen equipment codes K0738 (effective 10/28/2026) and E0424, E0431, E0433, E0434, E0439, E1390, E1391, E1392 (effective 04/13/2026, which has already passed). The practice must now obtain prior authorization before delivering these oxygen devices to Medicare Advantage members.
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What to do
Action · 8 steps
01REQUIREMENTS:
For HCPCS codes E0424, E0431, E0433, E0434, E0439, E1390, E1391, E1392: Already effective as of 04/13/2026 (past deadline).
02Confirm the practice has been obtaining prior authorization before delivering these oxygen equipment codes to Independence Blue Cross Medicare Advantage members and that providers document the face-to-face encounter and written order in the patient record.
03For HCPCS code K0738: Effective 10/28/2026 (now in effect).
04Billing team must:
1. Get prior authorization from Independence Blue Cross before scheduling delivery of K0738 portable oxygen concentrator equipment to Medicare Advantage members.
05Include documentation of the treating provider's face-to-face encounter and written order with the prior auth request.
062. Update charge entry so claims for K0738 do not go out without a prior authorization number attached.
073. Tell providers and front desk staff that K0738 oxygen equipment now requires prior authorization and a documented face-to-face encounter and written order before the device is delivered to the patient.
084. Watch for claims without prior authorization to be denied by the payer.
Codes mentioned
K0738E0424E0431E0433E0434E0439E1390E1391E1392
Original notice
MA05.017f, Home Oxygen Therapy
medpolicy.ibx.com · Always check the source before changing claims.
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