Medicare AdvantageBilling CodesMedium impact
MA07.022f, Capsule Endoscopy
Independence Blue Cross·Gastroenterology, Internal Medicine·Medical Policy
Effective date
Oct 20, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage reissued policy MA07.022f on capsule endoscopy with a minor update adding CPT code 0977T (upper gastrointestinal blood detection sensor capsule) to the experimental/investigational category, effective 10/20/2025. The policy continues noncovered gastrointestinal blood detection capsule procedures as experimental. Billing teams must ensure this new code is not billed as covered and is tracked separately.
Action Required
By 10/20/2025: Billing team must update billing system to classify CPT code 0977T as experimental/investigational for Independence Blue Cross Medicare Advantage plans. Configure system to prevent billing 0977T as a covered service and flag claims with this code for prior authorization denial or member notification of out-of-pocket responsibility. Verify that CPT codes 91110, 91111, and 91113 remain classified as medically necessary when submitted with appropriate ICD-10 diagnosis codes per policy criteria. Update internal code mapping and denial templates to reflect 0977T status. Inform providers and coding staff that GI blood detection capsule procedures using code 0977T are not covered under this plan.