CommercialAdministrativeLow impact
05.00.62i, Injectable Dermal Fillers for Cosmetic Procedures
Independence Blue Cross·Dermatology, Plastic Surgery·Medical Policy
We identified it
Jun 19, 2026
Summary
This is a routine annual policy reissue with no substantive changes to coverage or billing. The policy continues to classify injectable dermal fillers as cosmetic services not covered by most Independence Blue Cross commercial plans, with limited exceptions for trauma-related restoration. One HCPCS code (Q4112 for Cymetra) was added during the 07/01/2023 version and remains active.
Action Required
No immediate action required. This is a routine annual reissue with no changes. Billing teams should verify their system coding rules reflect the listed CPT/HCPCS codes and confirm that all dermal filler claims are being denied as cosmetic services per policy unless they meet the trauma exception criteria (documented recent trauma/accident with intent to restore pre-trauma state). If providers submit dermal filler claims, educate them that coverage is limited to facial lipodystrophy due to highly active antiretroviral therapy (use code G0429) on eligible plans; all other cosmetic filler uses are non-covered.