Medicare AdvantageBilling CodesLow impact
MA05.033e, External Breast Prostheses
Independence Blue Cross·Oncology, General Surgery, Plastic Surgery·Medical Policy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated MA05.033e to MA05.033f, adding two new ICD-10 diagnosis codes (C50.A1 and C50.A2 for malignant inflammatory neoplasms of breast) to the covered diagnoses for external breast prostheses. The policy intent and coverage criteria remain unchanged; this is a routine annual review update with retroactive effective date.
Action Required
Before October 1, 2025 (retroactively): Billing team must update diagnosis code mappings in the billing system to recognize C50.A1 (malignant inflammatory neoplasm of right breast) and C50.A2 (malignant inflammatory neoplasm of left breast) as covered diagnoses for external breast prostheses under Independence Blue Cross Medicare Advantage plan MA05.033f. Verify that claims using these new codes are approved for HCPCS codes L8000-L8002, L8015, L8020, L8030, and A4280. Review any previously denied claims from October 1, 2025 forward that used these diagnosis codes and consider for resubmission.