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MA07.048a, Instrument-Based Vision Screening
Effective date
Jan 1, 2024
Identified
Jun 19, 2026
Summary
Independence Blue Cross has reissued MA07.048a to reaffirm that instrument-based vision screening (CPT 99174, 99177) is considered part of the Evaluation and Management Service and is NOT eligible for separate reimbursement when billed alone or with other services. Providers must not bill members for this service. The policy applies to Medicare Advantage plans, including New Jersey MA lines effective 01/01/2024.
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What to do
Action · 8 steps
01By 01/15/2024: Billing team must implement the following changes.
02Update billing software to block or flag CPT 99174 and 99177 when submitted as standalone claims or in conjunction with E/M services under Independence Blue Cross Medicare Advantage plans.
03Ensure claims for these codes are NEVER submitted separately—they must be bundled into the E/M service at no additional charge.
04Educate all participating providers that member balance billing for these services is prohibited.
05Implement claim denial protocols for any CPT 99174 or 99177 claims submitted independently.
06Update internal billing guidelines and encounter forms to reflect that vision screening is included in E/M and should not be billed separately.
07Failure to comply will result in claim denials and potential overpayment recovery.
08This applies to all Independence Blue Cross Medicare Advantage members, including New Jersey MA plans.
Codes mentioned
9917499177
Original notice
MA07.048a, Instrument-Based Vision Screening
medpolicy.ibx.com · Always check the source before changing claims.