Medicare AdvantageBilling CodesMedium impact
MA08.007at, Medicare Part B vs. Part D Crossover Drugs
Independence Blue Cross·Pharmacy, Oncology, Infectious Disease +2 more·Pharmacy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross removed five terminated HCPCS drug codes (J9212, J3355, J2940, J1457, J0288) from Medicare Advantage Part B and Part D coverage attachments effective 01/01/2026, and revised CPT code 91323 in the vaccination attachment. Billing teams must remove these codes from systems and update claim submission logic to prevent denials for these drugs.
Action Required
By December 15, 2025: Billing team must update billing system to remove HCPCS codes J9212 (interferon alfacon-1), J3355 (urofollitropin), J2940 (somatrem), J1457 (gallium nitrate), and J0288 (amphotericin b cholesteryl sulfate complex) from all coverage attachments and claim submission rules for Independence Blue Cross Medicare Advantage plans. Review CPT code 91323 revision in Attachment C and update vaccination benefit logic accordingly. Verify that any claims submitted with these deleted codes on or after 01/01/2026 will be rejected. Update provider documentation and ordering guidelines to reflect code terminations. Failure to remove these codes will result in claim denials and rework.