CommercialCoverageMedium impact
09.00.58, Coronary Artery Calcium (CAC) Testing Using Computed Tomography (Independence Administrators)
Independence Blue Cross·Cardiology, Internal Medicine, Family Medicine·Medical Policy
Effective date
Apr 30, 2025
We identified it
Jun 19, 2026
Summary
Independence Administrators reissued their Coronary Artery Calcium (CAC) Testing policy effective 04/30/2025. This is a recent policy update that establishes coverage criteria, medical necessity requirements, and billing guidelines for CAC testing using computed tomography. Billing teams must review the full policy text to identify any changes from the previous version and update authorization and claims processing workflows accordingly.
Action Required
By 04/30/2025: Billing team must obtain and review the complete policy text from the provided URL (https://medpolicy.ibx.com/ibc/Commercial/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=04&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#commercial-09-00-58). Extract specific CPT/HCPCS codes, prior authorization requirements, and medical necessity documentation standards. Update billing software rules, prior authorization protocols, and provider encounter templates to align with the reissued policy. Communicate any changes to cardiology and preventive medicine providers. Claims submitted without compliance to the new policy requirements will be subject to denial or recoupment.