When does this change take effect?

This change is effective Mar 16, 2026.

Which billing codes are affected?

The following codes are affected: S9364.

Independence Blue CrossMedicare Advantage · Coverage · Medical Policy · Critical Care, Gastroenterology, General Surgery +5 moreMedium impact

MA08.008h, Total Parenteral Nutrition (TPN) / Intradialytic Parenteral Nutrition (IDPN)

Q: Who is affected by this change?

This affects Independence Blue Cross Critical Care, Gastroenterology, General Surgery, Nephrology, Pharmacy, Internal Medicine +2 more providers on Medicare Advantage plans.

Q: What do I need to do?

By March 16, 2026: (1) Billing team must remove coverage for hyperemesis gravidarum and intraperitoneal parenteral nutrition (IPN) from all claim adjudication rules and prior authorization workflows in the billing system. (2) Update all internal policy documentation and billing guidelines to reflect that these indications are no longer covered. (3) Providers must revise documentation templates and order forms to align with the new, more concise CMS-aligned documentation requirements for TPN initial and continuation therapy. (4) Claims submitted after 03/16/2026 with diagnoses of hyperemesis gravidarum or IPN will be denied as non-covered services. (5) Obtain and distribute the updated full policy text to all clinical and billing staff to ensure awareness of documentation requirement changes, particularly around evaluation timeframes (within 30 days prior to TPN initiation) and permanent impairment documentation.

Act

by Mar 16, 2026

Effective date

Mar 16, 2026

Identified

Jun 19, 2026

Summary

Independence Blue Cross MA08.008h policy for Total Parenteral Nutrition (TPN) and Intradialytic Parenteral Nutrition (IDPN) has been updated effective 03/16/2026. Two coverage indications have been deleted (hyperemesis gravidarum and intraperitoneal parenteral nutrition), and documentation requirements have been revised to align with CMS standards. Billing teams must update internal workflows to reflect these deletions and ensure compliance with the new, more concise documentation requirements.

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What to do

by Mar 16, 2026 · 5 steps

01Billing team must remove coverage for hyperemesis gravidarum and intraperitoneal parenteral nutrition (IPN) from all claim adjudication rules and prior authorization workflows in the billing system.

02Update all internal policy documentation and billing guidelines to reflect that these indications are no longer covered.

03Providers must revise documentation templates and order forms to align with the new, more concise CMS-aligned documentation requirements for TPN initial and continuation therapy.

04Claims submitted after 03/16/2026 with diagnoses of hyperemesis gravidarum or IPN will be denied as non-covered services.

05Obtain and distribute the updated full policy text to all clinical and billing staff to ensure awareness of documentation requirement changes, particularly around evaluation timeframes (within 30 days prior to TPN initiation) and permanent impairment documentation.

Codes mentioned

S9364

Original notice

MA08.008h, Total Parenteral Nutrition (TPN) / Intradialytic Parenteral Nutrition (IDPN)

medpolicy.ibx.com · Always check the source before changing claims.

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Related policy hubs

Independence Blue Cross policies Critical Care Gastroenterology General Surgery Nephrology Pharmacy Internal Medicine Oncology Pulmonology Code S9364

MA08.008h, Total Parenteral Nutrition (TPN) / Intradialytic Parenteral Nutrition (IDPN)

Summary

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What to do

Codes mentioned

Original notice

Related changes

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