Medicare AdvantageBilling CodesHigh impact
MA05.034a, Tracheostomy Care Supplies
Independence Blue Cross·Critical Care, Pulmonology, General Surgery +1 more·Medical Policy
Effective date
Mar 4, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage reissued policy MA05.034a effective 03/04/2026 with two critical billing changes: (1) Coverage for NOC code S8189 changed from Medically Necessary to Not Covered, and (2) AU modifier is now required when billing codes A4450, A4452, and A5120 with tracheostomy care supplies. The policy also clarifies refill timelines aligned with Medicare requirements.
Action Required
By 03/04/2026: Billing team must make two critical updates: (1) IMMEDIATELY STOP billing S8189 (NOT COVERED effective 03/04/2026) — any claims submitted with this code will be denied for Independence Blue Cross Medicare Advantage members. (2) Update billing software to REQUIRE AU modifier when billing codes A4450 (nonwaterproof tape), A4452 (waterproof tape), and A5120 (skin barrier wipes/swabs) with tracheostomy care supplies. Add validation rules in claim submission system to prevent submission of these three codes without AU modifier attached. Update provider billing guidelines and training materials to reflect modifier requirement. Medical record documentation must be maintained to support medical necessity for quantities exceeding the listed maximums per the policy table, or excess quantities will be denied.