Medicare AdvantageCoverageHigh impact
MA05.044v, Durable Medical Equipment (DME)
Independence Blue Cross·Physical Therapy, Occupational Therapy, Geriatrics +2 more·Medical Policy
Effective date
Nov 10, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross MA05.044v DME policy has been updated to clarify DME coverage criteria and add 9 HCPCS codes (A4212, A4337, A4461, A4860, A4932, A6228, A6229, A6230, A6413) to the non-covered list as they do not meet Medicare's DME definition. Billing teams must immediately stop reimbursement requests for these codes and update internal systems to reflect non-covered status.
Action Required
By November 10, 2025: (1) Billing team must update billing system to mark HCPCS codes A4212, A4337, A4461, A4860, A4932, A6228, A6229, A6230, and A6413 as non-covered under Independence Blue Cross Medicare Advantage plans. (2) Configure system to automatically deny or reject claims containing these codes with explanation of non-DME status. (3) Update all DME claim submission workflows and encounter forms to exclude these codes from reimbursement requests. (4) DME suppliers must review existing patient records and communicate to providers that these items are no longer reimbursable. (5) Notify all ordering providers in writing of the code changes. Failure to implement will result in claim denials and potential recoupment of claims already paid for these codes under the previous policy.