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Independence Blue CrossMedicare Advantage · Billing Codes · Medical Policy · Neurosurgery, Orthopedics, Pain Management +1 moreMedium impact

MA11.097f, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis

Effective date
Jan 1, 2026
Identified
Jun 19, 2026

Summary

Independence Blue Cross updated MA11.097f to reflect CPT code changes effective 01/01/2026: CPT 0275T was terminated and replaced with CPT codes 62330 and 62331 for percutaneous image-guided lumbar decompression (PILD). PILD remains experimental/investigational and NOT covered except through Coverage with Evidence Development (CED) clinical trials. Billing requires Modifier Q0 with CPT 62330/62331 or HCPCS G0276 for approved CED studies.

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What to do

Action · 6 steps
01By 12/15/2025: Billing team must update billing software to discontinue use of CPT 0275T for PILD procedures.
02Update system to recognize CPT 62330, 62331, and HCPCS G0276 as the valid codes for PILD when performed in CED clinical trials only.
03Configure system to automatically append Modifier Q0 to CPT 62330/62331 claims and require documentation that patient is enrolled in a Medicare-approved CED clinical study.
04Train billing staff that all non-CED PILD claims will be denied as experimental/investigational.
05Update claim denial templates to direct providers to CED clinical trial enrollment requirements.
06Effective 01/01/2026, any PILD claims submitted with CPT 0275T will be rejected; claims must use new codes with proper modifiers and CED documentation.

Codes mentioned

6233062331G0276

Original notice

MA11.097f, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis
medpolicy.ibx.com · Always check the source before changing claims.
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Related changes

See all Independence Blue Cross changes →
MA11.097e, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal StenosisMediumNo effective date · Medical PolicyMA11.097f, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal StenosisHighEffective Jan 1, 2026 · Medical Policy11.15.22d, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal StenosisMediumNo effective date · Medical Policy11.15.22e, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal StenosisMediumEffective Jan 1, 2026 · Medical PolicyBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesNeurosurgeryOrthopedicsPain ManagementGeneral SurgeryCode 62330Code 62331Code G0276

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