Summary
Independence Blue Cross updated MA00.047r (Musculoskeletal Services) to MA00.047u effective 01/01/2026 as part of annual CPT code updates. CPT 27279 narrative was revised and CPT 27445 was terminated/removed from coverage. Billing teams must verify their systems reflect the removal of CPT 27445 and any changes to CPT 27279 documentation requirements for spinal and joint surgical procedures under Medicare Advantage plans.
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What to do
Action · 5 steps
01By 01/01/2026: Billing team must immediately update billing system to REMOVE CPT 27445 from all IBX Medicare Advantage claims (this code is no longer covered under policy MA00.047u).
02Update CPT 27279 documentation requirements in the EHR/billing system to reflect the revised narrative in MA00.047u.
03Verify that all spinal and joint surgical procedures referenced in Attachments A and B of the policy continue to require precertification through Carelon Medical Benefits Management.
04Communicate to providers that CPT 27445 cannot be billed to IBX MA plans effective 01/01/2026; claims submitted with this code will be denied.
05Reference the updated MA00.047u policy (not the superseded MA00.047r) for all prior authorization determinations.
Codes mentioned
2727927445
Original notice
MA00.047r, Musculoskeletal Services
medpolicy.ibx.com · Always check the source before changing claims.