CommercialCoverageMedium impact
07.05.02t, Wireless Capsule Endoscopy for Gastrointestinal (GI) Disorders
Independence Blue Cross·Gastroenterology, Internal Medicine·Medical Policy
Effective date
Oct 20, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued policy 07.05.02t on wireless capsule endoscopy, adding CPT code 0977T (upper gastrointestinal blood detection sensor capsule) to the experimental/investigational category, making it non-covered effective 10/20/2025. This change clarifies that blood detection capsule procedures will not be reimbursed by the plan.
Action Required
By 10/20/2025: Billing team must update billing system to flag CPT code 0977T as non-covered/experimental for Independence Blue Cross commercial plans. Add edit rule to deny claims or generate patient notification prior to service. Providers and front desk staff must be informed that upper gastrointestinal blood detection capsule (CPT 0977T) is not a covered benefit and patients should be counseled before scheduling. Continue to process CPT codes 91110 and 91111 as medically necessary when medical necessity criteria are met. Failure to identify 0977T as non-covered will result in claim denials and potential patient balance issues.