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Medicare AdvantageBilling CodesMedium impact

MA08.007as, Medicare Part B vs. Part D Crossover Drugs

Independence Blue Cross·Pharmacy
Effective date
Sep 22, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

Medicare Advantage has updated their policy regarding crossover drugs between Medicare Part B and Part D coverage. This medical coding policy change affects how certain medications are billed and processed when they can be covered under either Medicare benefit.

Action Required

Action needed
By September 22, 2025: Billing team must review and update coding procedures for medications that can be covered under both Medicare Part B and Part D. Verify current crossover drug guidelines in billing system and update encounter forms to ensure proper benefit determination. Contact Medicare Advantage plans for specific drug coverage guidelines to avoid claim denials.