Summary
Independence Blue Cross reissued MA05.031c on 04/01/2026 to communicate its continuing position on patient lifts for Medicare Advantage members in New Jersey. The policy removes face-to-face requirements for seven patient lift HCPCS codes (E0630, E0635, E0636, E0639, E0640, E1035, E1036) and clarifies coverage criteria, reimbursement edits, and excluded items (bathroom/toilet lifts and home modifications).
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What to do
Action · 6 steps
01By 01/01/2024, the billing team must: 1) Remove face-to-face visit requirements from authorization workflows for HCPCS codes E0630, E0635, E0636, E0639, E0640, E1035, and E1036 in the billing system.
022) Update prior authorization templates and provider communication to reflect that face-to-face exams are no longer required for these patient lift codes.
033) Verify that reimbursement edits in Column I/Column II are configured correctly (all patient lift codes reimburse at E0621 rates; do not separately reimburse duplicate codes).
044) Ensure denial logic flags bathroom/toilet lifts and home modification charges as non-covered per Medicare policy.
055) Audit any pending claims for these codes submitted since 01/01/2024 and reprocess if previously denied due to missing face-to-face documentation.
06Contact Independence Blue Cross New Jersey MA plan administrator if clarification is needed on individual member benefits.
Codes mentioned
E0621E0630E0635E0636E0639E0640E1035E1036
Original notice
MA05.031c, Patient Lifts
medpolicy.ibx.com · Always check the source before changing claims.