CommercialCoverageMedium impact
09.00.36m, First-Trimester Prenatal Screening for Fetal Aneuploidy Using Fetal Ultrasound Markers
Independence Blue Cross·OB-GYN, Radiology·Medical Policy
Effective date
Feb 19, 2025
We identified it
Jun 19, 2026
Summary
Policy 09.00.36m has been reissued effective 02/19/2025 regarding first-trimester prenatal screening for fetal aneuploidy using fetal ultrasound markers. The billing team must review the updated coverage criteria, medical necessity requirements, and any changes to applicable billing codes or prior authorization requirements for this prenatal screening service.
Action Required
By 02/19/2025: Billing team must obtain and review the complete policy text at https://medpolicy.ibx.com/ibc/Commercial/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=02&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#commercial-09-00-36m to identify specific billing codes, prior authorization requirements, and medical necessity documentation standards for first-trimester prenatal ultrasound screening. Update billing system rules, prior authorization workflows, and provider encounter templates accordingly. Communicate any changes to OB/GYN providers and front desk staff regarding new documentation requirements or prior auth procedures. Failure to implement required changes may result in claim denials for non-compliant submissions.