CommercialAdministrativeMedium impact
11.14.23d, Surgical Treatment of Femoroacetabular Impingement (Independence Administrators)
Independence Blue Cross·Orthopedics, Sports Medicine·Medical Policy
We identified it
Jun 19, 2026
Summary
This is a reissue of the Independence Administrators FAI surgical treatment policy with no substantive clinical changes. The policy clarifies that it applies ONLY to Independence Administrators claims (not Commercial Independence members) and excludes groups enrolled in the UM vendor program. Billing teams must verify member eligibility and plan type before billing FAI procedures, as Commercial Independence members now use AIM Specialty Health guidelines instead.
Action Required
REQUIREMENTS:
- Immediately: Billing team must verify that each patient with FAI surgery claims is covered under Independence Administrators (not Commercial Independence) BEFORE submitting claims for CPT 29914, 29915, 29916, or 27299.
- Update claim submission workflows in billing system to include a verification step for plan type and UM vendor enrollment status. Denote which patients fall under Independence Administrators vs. Commercial Independence.
- For any Commercial Independence members presenting for FAI surgery, route claims to AIM Specialty Health guidelines per policy 00.01.66 (Musculoskeletal Services) instead of this policy.
- Instruct front-desk and pre-authorization staff to confirm with payers that groups have NOT enrolled in the UM vendor program before authorizing or processing FAI procedures.
- Consequence: Claims submitted for Commercial Independence members or UM vendor-enrolled groups will be denied as this policy is no longer applicable to those members.