Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
Independence Blue CrossMedicare Advantage · Coverage · Medical Policy · Cardiology, Pain ManagementMedium impact

MA00.005ao, Experimental/Investigational Services

Act
by Apr 1, 2025
Effective date
Apr 1, 2025
Identified
Jun 19, 2026

Summary

Independence Blue Cross updated MA00.005ao to MA00.005at effective 04/01/2025, adding 15 new experimental/investigational CPT and HCPCS codes, removing 6 codes to other policies, terminating 22 obsolete codes, and revising one HCPCS narrative. Billing teams must update systems to deny claims for newly added codes (0535U, 0541U, 0542U, 0545U, 0546U, 0547U, 0548U, 0550U, 0551U, C8004, C8005, G0183, G0566, Q4360, S4024) and stop billing removed codes (33289, 93264, C2624, G0555, C9784, C9785) under this policy, while routing those removed codes to appropriate replacement policies.

Get alerts when payers change rules like this one

We check Independence Blue Cross and other payers every day and email you when a change matches your specialty and state.

Get Independence Blue Cross alertsPolicy Monitoring is free. No card required.

What to do

by Apr 1, 2025 · 6 steps
01Billing team must update claims processing system to deny claims for newly experimental/investigational CPT codes (0535U, 0541U, 0542U, 0545U, 0546U, 0547U, 0548U, 0550U, 0551U) and HCPCS codes (C8004, C8005, G0183, G0566, Q4360, S4024) as non-covered.
02Update billing software rules to flag and remove codes 33289, 93264, C2624, G0555, C9784, C9785 from this policy and route to MA11.119 (pulmonary artery pressure sensors) or MA11.051 (obesity/bariatric surgery) as appropriate.
03Remove terminated codes (0553T, 0567T, 0568T, M0220-M0247, Q0220-Q0247) from all billing templates and encounter forms.
04Replace S4988 with E0201 in billing system and provider documentation.
05Review and revise C1739 narrative in system per attachment.
06Providers must stop submitting claims for these codes under MA00.005ao policy; claims submitted without prior authorization through replacement policies will be denied.

Codes mentioned

3328993264C8004C8005G0183G0566Q4360S4024C2624G0555C9784C9785M0220M0221M0222M0223M0240M0241M0243M0244M0245M0246M0247Q0220Q0221Q0222Q0240Q0243Q0244Q0245Q0247S4988E0201C1739

Original notice

MA00.005ao, Experimental/Investigational Services
medpolicy.ibx.com · Always check the source before changing claims.
View original ↗

Related changes

See all Independence Blue Cross changes →
12.01.01bp, Experimental/Investigational ServicesHighEffective Apr 1, 2025 · Medical PolicyMA11.119, Implantable Pulmonary Artery Pressure Sensors for Heart Failure ManagementLowEffective Jan 13, 2025 · Medical PolicyMA11.119, Implantable Pulmonary Artery Pressure Sensors for Heart Failure ManagementMediumEffective Jan 13, 2025 · Medical Policy00.01.25bs, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative ServicesHighEffective Apr 1, 2025 · NetworkBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesCardiologyPain ManagementCode 33289Code 93264Code C8004Code C8005Code G0183Code G0566Code Q4360Code S4024Code C2624Code G0555Code C9784Code C9785Code M0220Code M0221Code M0222Code M0223Code M0240Code M0241Code M0243Code M0244Code M0245Code M0246Code M0247Code Q0220Code Q0221Code Q0222Code Q0240Code Q0243Code Q0244Code Q0245Code Q0247Code S4988Code E0201Code C1739

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account