Medicare AdvantageBilling CodesMedium impact
MA05.057f, Upper-Limb Prostheses
Independence Blue Cross·Orthopedics, Physical Therapy, Occupational Therapy +1 more·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage policy MA05.057f has been updated effective 04/01/2026 with HCPCS code changes for upper-limb prostheses. Three partial hand prosthesis codes (L6000, L6010, L6020) have been deleted, one code (L6028) has been revised with expanded description, and a new catch-all code (L7499) has been added. Billing teams must update their systems to reflect these code changes to ensure proper claim submission and avoid denials.
Action Required
By March 15, 2026: Billing team must update billing software and claims submission systems to implement the following HCPCS code changes for Independence Blue Cross Medicare Advantage (MA) plans: (1) DELETE codes L6000, L6010, and L6020 from all upper-limb prosthesis billing templates and drop-down menus; (2) ADD code L7499 (upper extremity prosthetic devices, not otherwise specified) as the replacement catch-all code; (3) REVISE code L6028 description in system to reflect the expanded definition: 'Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by L6692'. Update provider ordering forms and prosthetist claim preparation instructions. Train billing staff on new code hierarchy. Failure to implement these changes will result in claim rejections and delayed reimbursement for upper-limb prosthesis claims submitted on or after 04/01/2026.