CommercialCoverageMedium impact
06.02.14i, In Vitro Chemosensitivity and Chemoresistance Assays
Independence Blue Cross·Oncology, Pathology·Medical Policy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued Policy 06.02.14i on 06/24/2026 with no substantive changes to coverage status. In vitro chemosensitivity and chemoresistance assays remain non-covered as experimental/investigational. CPT codes 81535, 81536, and 0564T are designated for this test, but billing these codes will result in denial under this plan.
Action Required
REQUIREMENTS:
- Billing team must ensure claims using CPT 81535, 81536, 0564T, or 89240 for in vitro chemosensitivity/chemoresistance assays are NOT submitted to Independence Blue Cross Commercial plans, as these services are non-covered.
- Update billing system denial rules and claim edits to flag these codes when submitted under IBX Commercial product lines.
- Educate ordering providers and patient care coordinators that these assays are not eligible for reimbursement; patients should be informed in advance that they will be responsible for out-of-pocket costs.
- No action required regarding effective date, as this is a reissue with no changes—existing denial protocols remain in effect.
- Verify no prior authorization processes exist for these codes, as the service is categorically excluded, not subject to case-by-case review.