CommercialBilling CodesMedium impact
09.00.36m, First-Trimester Prenatal Screening for Fetal Aneuploidy Using Fetal Ultrasound Markers
Independence Blue Cross·OB-GYN, Radiology·Medical Policy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross has reissued policy 09.00.36m with no substantive changes to first-trimester prenatal screening coverage criteria. The policy continues to cover nuchal translucency screening combined with maternal serum markers (PAPP-A and hCG) as medically necessary, while maintaining non-coverage for nuchal translucency alone in singleton pregnancies and after negative cell-free DNA screening. Three CPT codes (0124U, 0125U, 0126U) have been terminated and are no longer billable.
Action Required
Immediately: Billing team must remove terminated CPT codes 0124U, 0125U, and 0126U from all billing systems, encounter templates, and fee schedules. These codes can no longer be billed to Independence Blue Cross effective upon the policy reissue date (06/24/2026). Verify that claims denials related to these codes are processed as non-covered services. Update coding reference materials and provider bulletins to reflect the termination. Providers submitting claims with these codes will receive denials; ensure front-line staff are aware to redirect providers to compliant codes (76813, 76814, 81508, 82397, 84163, 84702) for first-trimester aneuploidy screening.