CommercialCoverageMedium 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 Medical Policy 00.01.24n with no substantive changes to the policy itself, but added photocoagulation of macular drusen (CPT 67299) to the list of not medically necessary services effective 01/12/2026. This service is now non-covered and claims will be denied. The policy also clarifies that all listed obsolete diagnostic tests and medical services remain non-covered.
Action Required
Before 01/12/2026: Billing team must update billing system and claims denial rules to flag CPT 67299 (photocoagulation of macular drusen) as not medically necessary and non-covered under Independence Blue Cross commercial plans. Update clinical documentation templates and provider alerts to inform ophthalmology providers that this procedure is not covered. Configure system to automatically deny claims with CPT 67299 and generate patient liability notices. Verify that all other codes listed in this policy (87003, 29999, M0100, M0301, P2028-P2038, etc.) remain configured as non-covered. Communicate policy change to ophthalmology providers and front desk staff to prevent claim submission.