Medicare AdvantageCoverageHigh impact
MA00.005as, Experimental/Investigational Services
Independence Blue Cross·PA · Orthopedics, Urology, Cardiology +3 more·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated its Experimental/Investigational Services policy (MA00.005as to MA00.005at) effective 04/01/2026, adding 7 new codes (CPT 0614U, 0615U; HCPCS A8005, A8006, C1743, C8010, G0680) and 3 unlisted code categories to the non-covered list, while removing 6 codes that are now addressed in separate medical policies or have changed coverage status. Billing teams must immediately identify and deny claims for the newly added codes and services.
Action Required
By 04/01/2026: Billing team must update claim processing system and billing software to immediately DENY claims containing the following newly non-covered experimental/investigational codes: CPT 0614U, 0615U; HCPCS A8005, A8006, C1743, C8010, G0680; and unlisted codes 20999 (autologous tissue cell harvesting/application and hematopoietic tissue cells), and E1399 (ROMTech PortableConnect and ROMTech AccuAngle remote monitoring systems). Additionally, REMOVE from the experimental/investigational denial list: CPT 0935T, 51721, 55881, 55882 (now covered under separate MA11.120 and MA11.004 policies); HCPCS C9756 (eligible for coverage); and L2006 (medically necessary). Update all claim editing rules, encounter forms, and billing guidelines to reflect these changes. Communicate with providers and front desk staff that these codes are no longer covered effective 04/01/2026. Failure to implement will result in improper denials (for removed codes) or improper approvals (for newly added codes).