Medicare AdvantageCoverageMedium impact
MA00.001f, Not Medically Necessary Services and Obsolete or Unreliable Diagnostic Tests
Independence Blue Cross·Ophthalmology, Wound Care, Endocrinology +1 more·Medical Policy
Effective date
Jan 12, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage reissued policy MA00.001f on 01/12/2026 with no substantive changes, but adds two medical services (photocoagulation of macular drusen and electromagnetic stimulation for wound care with specific exceptions) to the non-covered list and introduces three new billing codes (CPT 67299, HCPCS G0282, G0295). Billing team must update system edits to deny claims for these newly listed services.
Action Required
By 01/12/2026: Billing team must update claim denial rules in billing system to flag and deny CPT 67299 (photocoagulation of macular drusen), HCPCS G0282 (electrical stimulation for wound care), and HCPCS G0295 (electromagnetic stimulation for wound care) when submitted to Independence Blue Cross Medicare Advantage plans, except for G0282 and G0295 when used for chronic stage III/IV pressure ulcers, arterial insufficiency ulcers, diabetic ulcers, or venous stasis ulcers. Update claim scrubbing logic to automatically deny these codes without these specific diagnoses. Communicate changes to providers and front desk staff to avoid claim submission errors. Claims submitted without proper exceptions will be denied as not medically necessary.