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00.06.02aw, Preventive Care Services
Act
by Sep 30, 2025
Effective date
Oct 1, 2025
Identified
Jun 19, 2026
Summary
Independence Blue Cross updated preventive care policy 00.06.02aw to 00.06.02ba, effective 10/01/2025, making targeted HCPCS and ICD-10 code updates. Key changes include: adding HCPCS J0525 for colorectal cancer screening services (replacing S0074), adding HCPCS A4288 for breastfeeding supplies, clarifying J7300 intrauterine contraceptive description, and adding new ICD-10 codes for financial insecurity counseling and BRCA genetic testing. Billing teams must update systems to recognize the new/replaced codes and ensure proper claim adjudication at $0 cost-share for qualifying preventive services.
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What to do
by Sep 30, 2025 · 9 steps
01Billing team must update billing system and claim submission software to implement the following changes.
02Replace HCPCS code S0074 with J0525 for all preventive colorectal cancer screening procedure services.
03Add HCPCS code A4288 to covered breastfeeding support/counseling and supplies.
04Update J7300 description in system to specify 'Intrauterine copper contraceptive (paragard)' for accurate coding and adjudication.
05Add new ICD-10 diagnosis codes Z59.861, Z59.868, Z59.869 to encounter forms and billing logic for counseling interventions to prevent perinatal depression.
06Add new ICD-10 diagnosis codes Z85.4A and Z86.00A for BRCA-related cancer risk assessment and genetic counseling claims.
07Ensure all preventive services using these codes are adjudicated at $0 cost-share when performed at participating providers.
08Verify member benefit contracts to confirm coverage applicability.
09Notify providers and front desk staff of code transitions to prevent claim rejections and denials.
Codes mentioned
J0525S0074A4288J7300Z59.861Z59.868Z59.869Z85.4AZ86.00A
Original notice
00.06.02aw, Preventive Care Services
medpolicy.ibx.com · Always check the source before changing claims.
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