Medicare AdvantageBilling CodesLow impact
MA05.060d, External Infusion Pumps
Independence Blue Cross·Oncology, Endocrinology, Pain Management +2 more·Pharmacy
Effective date
Jul 1, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated MA05.060d to MA05.060h, adding HCPCS code J7356 (foscarbidopa/foslevodopa injection) effective 07/01/2025, retroactively. The policy reissued on 12/10/2025 confirms continuing coverage for external infusion pumps under existing medical necessity criteria for chronic iron overload, hepatocellular carcinoma, colorectal cancer, intractable cancer pain, and diabetes mellitus.
Action Required
By January 31, 2025: Billing team must verify that billing system is updated to recognize HCPCS code J7356 (foscarbidopa/foslevodopa injection) for external infusion pump claims with retroactive effective date of 07/01/2025. Confirm that claims submitted on or after 07/01/2025 using J7356 are adjudicated under the updated MA05.060h policy. No workflow changes required; this is a code addition to an existing policy with unchanged coverage criteria. Verify records for any claims submitted between 07/01/2025 and policy publication date that may require reprocessing.