Medicare AdvantageBilling CodesLow impact
MA07.023m, Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
Independence Blue Cross·Gastroenterology, Internal Medicine, General Surgery·Medical Policy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage reissued policy MA07.023m for upper gastrointestinal endoscopy (diagnostic and therapeutic) effective 10/01/2025, adding four ICD-10 diagnosis codes related to Fontan-associated conditions (I27.840, I27.841, I27.848, I27.849) to Attachment A. This is a minor reissue with no changes to coverage criteria, medically necessary indications, or billing codes.
Action Required
By 10/01/2025: Billing team must update diagnosis code reference tables to include the four newly added Fontan-associated ICD-10 codes (I27.840, I27.841, I27.848, I27.849) in Attachment A for Independence Blue Cross Medicare Advantage claims. Update billing system lookup tables and encounter forms to recognize these codes as covered diagnoses for upper endoscopy procedures. No changes to procedure codes, coverage criteria, or prior authorization requirements. Verify that claims submitted with these new diagnosis codes are processed without denial.