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00.01.25bs, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Act
by Apr 1, 2025
Effective date
Apr 1, 2025
Identified
Jun 19, 2026
Summary
Independence Blue Cross updated policy 00.01.25bs to 00.01.25bv, effective 04/01/2025, removing 5 CPT/HCPCS codes and adding 41 new codes related to durable medical equipment, laboratory, radiology, and physical medicine services. Additionally, 13 existing code narratives were revised. Billing teams must update their systems to recognize the new codes and discontinue billing the deleted codes to avoid claim denials.
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What to do
by Apr 1, 2025 · 6 steps
01Billing team must immediately update billing software and claims submission systems to remove the following deleted codes from all DME, laboratory, radiology, and PM&R billing rules: A9155, L8010, S4988, 0500T, and 0564T.
02Add the 41 new codes to the system's allowed code lists for IBX commercial PPO members: A9154, E0201, E1022, E1023, E1032, E1033, E1034, G0566, G0567, L0720, L1933, L1952, L5827, L6028-L6033, L6037, L6700, L7406, and 0531U-0551U.
03Providers and billing staff must review the 13 revised code narratives (A4453, A4459, E1028, E1801, E1811, E1816, E1818, E1841, L1932, L1951, L1971, L6692, L6698) and update documentation templates accordingly.
04Claims submitted on or after April 1 using deleted codes will be denied; claims using new codes submitted before system updates are complete may be rejected.
05Update fee schedules, superbill templates, and provider communication materials.
06Communicate changes to all billing and clinical staff handling IBX commercial PPO claims.
Codes mentioned
A9155A9154L8010E0201E1022E1023E1032E1033E1034S4988G0566G0567L0720L1933L1952L5827L6028L6029L6030L6031L6032L6033L6037L6700L7406A4453A4459E1028E1801E1811E1816E1818E1841L1932L1951L1971L6692L6698
Original notice
00.01.25bs, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
See all Independence Blue Cross changes →MA05.044u, Durable Medical Equipment (DME)MediumEffective Oct 1, 2025 · Medical Policy05.00.21ag, Durable Medical Equipment (DME) and Consumable Medical SuppliesMediumEffective Apr 1, 2025 · Medical PolicyMA05.057d, Upper-Limb ProsthesesMediumEffective Apr 1, 2025 · Medical PolicyMA05.057d, Upper-Limb ProsthesesMediumEffective Apr 1, 2025 · Medical PolicyBrowse every Independence Blue Cross change in the policy list
Related policy hubs
Independence Blue Cross policiesPA policy changesNJ policy changesPM&R (Physical Medicine & Rehab)RadiologyOrthopedicsPodiatryGeneral SurgeryCode A9155Code A9154Code L8010Code E0201Code E1022Code E1023Code E1032Code E1033Code E1034Code S4988Code G0566Code G0567Code L0720Code L1933Code L1952Code L5827Code L6028Code L6029Code L6030Code L6031Code L6032Code L6033Code L6037Code L6700Code L7406Code A4453Code A4459Code E1028Code E1801Code E1811Code E1816Code E1818Code E1841Code L1932Code L1951Code L1971Code L6692Code L6698