Medicare AdvantageBilling CodesHigh impact
MA11.096c, Percutaneous Discectomy
Independence Blue Cross·Neurosurgery, Orthopedics, Pain Management·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage policy MA11.096c reissues its position that percutaneous discectomy remains experimental/investigational and not covered. CPT code 0275T was terminated and removed; CPT codes 62330 and 62331 were added as experimental/investigational; CPT codes 0274T and 62287 received revised narratives. All percutaneous discectomy procedures remain non-covered for Medicare Advantage members effective 01/01/2026.
Action Required
By 01/01/2026: Billing team must update billing software to reflect CPT code 0275T as terminated and removed from all claim submissions. Add CPT codes 62330 and 62331 to the system with experimental/investigational status and configure them to automatically deny claims under Independence Blue Cross Medicare Advantage plans. Update claim edits to deny all percutaneous discectomy claims (including codes 0274T, 62287, 62330, 62331, 62380) with explanation code indicating experimental/investigational service not covered. Providers must be notified that these procedures are not eligible for reimbursement and members should be informed of non-coverage before any services are rendered. Failure to implement these changes will result in claim denials and potential compliance issues.