By 02/02/2026: Billing team must update billing software and claim validation rules to remove the following 15 ICD-10 diagnosis codes from the covered diagnoses list for CPT 67221 and 67225 verteporfin PDT claims: B39.3, B39.4, B39.5, B39.9, D18.09, H32, H35.059, H35.3290, H35.3291, H35.3292, H35.3293, H35.711, H35.712, H35.713, H35.719, and all H44.2x codes listed (H44.20, H44.21, H44.22, H44.23, H44.2A1-A9, H44.2B1-B9, H44.2C1-C9, H44.2D1-D9, H44.2E1-E3, H44.2E9). Update claim edits to deny or reject claims submitted with these diagnosis codes paired with CPT 67221/67225 for Independence Blue Cross Medicare Advantage members. Notify providers that only the covered diagnoses (exudative AMD with CNV, presumed ocular histoplasmosis, pathologic myopia) are eligible for PDT coverage. Failure to implement these changes will result in incorrectly approved claims that should be denied, leading to potential overpayment recovery.