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Independence Blue CrossMedicare Advantage · Billing Codes · Medical Policy · Neurosurgery, Pain Management, OrthopedicsHigh impact

MA11.097f, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis

Effective date
Jan 1, 2026
Identified
Jun 19, 2026

Summary

Independence Blue Cross updated MA11.097f to reflect CPT code changes effective 01/01/2026: CPT 0275T was removed and CPT codes 62330, 62331 were added as experimental/investigational codes for PILD procedures. PILD for lumbar spinal stenosis remains non-covered except when performed in Medicare-approved CED clinical trials using the specified CPT codes with Modifier Q0 or HCPCS G0276.

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What to do

Action · 6 steps
01By 01/01/2026: Billing team must update billing system to discontinue use of CPT 0275T for PILD procedures.
02Update system to recognize CPT 62330 and 62331 as valid experimental/investigational codes ONLY when billed with Modifier Q0 or as HCPCS G0276 for CED clinical trials.
03Modify claims submission rules to reject any PILD claims (62330, 62331, G0276) submitted without evidence of patient enrollment in a Medicare-approved CED clinical trial; all other PILD claims will be denied as experimental.
04Train billing staff and providers to verify CED trial enrollment status before claim submission.
05Update encounter documentation templates to capture CED trial participation and approved device information (Vertos Medical, VertiFlex).
06Review all pending and in-progress PILD claims to identify any using 0275T and resubmit with correct codes if applicable.

Codes mentioned

6233062331G0276

Original notice

MA11.097f, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis
medpolicy.ibx.com · Always check the source before changing claims.
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Related changes

See all Independence Blue Cross changes →
MA11.097e, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal StenosisMediumNo effective date · Medical PolicyMA11.097f, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal StenosisMediumEffective Jan 1, 2026 · Medical Policy11.15.22d, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal StenosisMediumNo effective date · Medical Policy11.15.22e, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal StenosisMediumEffective Jan 1, 2026 · Medical PolicyBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesNeurosurgeryPain ManagementOrthopedicsCode 62330Code 62331Code G0276

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