CommercialCoverageLow impact
00.01.24n, Not Medically Necessary Services and Obsolete or Unreliable Diagnostic Tests
Independence Blue Cross·Ophthalmology·Medical Policy
Effective date
Jan 12, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued policy 00.01.24n with no substantive changes to the list of non-covered obsolete or unreliable diagnostic tests and medical services. One new service—photocoagulation of macular drusen (CPT 67299)—was added to the non-covered services list effective 01/12/2026. Billing teams must deny claims for this procedure as not medically necessary.
Action Required
By 01/12/2026: Billing team must update claims denial rules in billing software to automatically deny CPT 67299 (photocoagulation of macular drusen) with reason code indicating 'not medically necessary' per Independence Blue Cross policy 00.01.24n. Ensure all claims submitted on or after this date for this procedure are rejected. Notify ophthalmology providers of the non-covered status to prevent inappropriate ordering and patient balance issues.