Medicare AdvantageCoverageMedium impact
MA06.004d, In Vivo Allergy Sensitivity Testing
Independence Blue Cross·Allergy & Immunology, Dermatology, Internal Medicine +2 more·Medical Policy
Effective date
Aug 25, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage reissued policy MA06.004d with revised coverage criteria for in vivo allergy testing. Key change: Provocation/neutralization testing moved from Experimental/Investigational to Not Covered section effective 08/25/2025. Percutaneous, intracutaneous, and mucous membrane challenge test criteria have been revised. Billing team must immediately stop reimbursing provocation/neutralization tests and update denial procedures.
Action Required
By 08/25/2025: Billing team must update claim adjudication system to deny all provocation/neutralization testing claims for food allergies and other allergens under Independence Blue Cross Medicare Advantage plans. Remove these codes from medically necessary/covered lists. Providers must be notified via bulletin that provocation/neutralization testing is no longer covered and claims will be denied. Ensure claims submitted on or after 08/25/2025 with provocation/neutralization testing are auto-denied with explanation that this service moved to Not Covered section. Update internal documentation requirements to reflect revised criteria for percutaneous (scratch/puncture/prick), intracutaneous (intradermal), and mucous membrane challenge tests per policy details. Failure to implement will result in improper reimbursement and potential overpayments to providers.