CommercialCoverageMedium impact
00.01.24m, Not Medically Necessary Services and Obsolete or Unreliable Diagnostic Tests
Independence Blue Cross·Medical Policy
Effective date
Sep 8, 2025
We identified it
Jun 19, 2026
Summary
This policy updates coverage and medical necessity criteria for services deemed not medically necessary and obsolete or unreliable diagnostic tests. The change affects reimbursement decisions and may require updated documentation to support medical necessity for certain services.
Action Required
Before September 8, 2025: Review current billing practices for potentially obsolete diagnostic tests and services that may be deemed not medically necessary. Update documentation requirements to ensure medical necessity is properly supported. Monitor for specific code lists and coverage criteria once full policy details are released.