CommercialBilling CodesMedium impact
11.15.15h, Percutaneous Discectomy
Independence Blue Cross·PA · Neurosurgery, Orthopedics, Pain Management·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated Medical Policy 11.15.15h to reflect CPT code changes effective 01/01/2026. CPT code 0275T (terminated) was removed, and CPT codes 62330 and 62331 (percutaneous decompression procedures) were added as Experimental/Investigational. The policy maintains its non-coverage position for all percutaneous discectomy procedures due to insufficient safety and effectiveness evidence, despite FDA device approvals.
Action Required
By 12/31/2025: Billing team must update billing system to remove CPT code 0275T from all active billing configurations and deny/reject claims if this code is submitted after 01/01/2026. Add CPT codes 62330 and 62331 to the experimental/investigational code list in billing software to automatically deny claims and generate patient notifications that these procedures are non-covered. Update claim scrubbing rules to flag CPT 62330 and 62331 with denial reason 'Experimental/Investigational - Not Covered' for all diagnoses. Notify providers and front desk staff that percutaneous discectomy procedures (all codes including 62330, 62331, 62380, 0274T, 62287) are non-covered under commercial plans; claims will be denied without exception. Communicate to patients upfront that these procedures require out-of-pocket payment.