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​Change to policy on laboratory services for members enrolled in HMO or HMO-POS products​​

April 24, 2023

Effective July 31, 2023, Independence Blue Cross will update its claim payment policy on laboratory services for members enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) products for Commercial and Medicare Advantage members.

Policy number 00.03.07ak and MA00.030ac will be updated to communicate the removal of provider specialty exceptions in the office setting for certain laboratory services identified in attachment B1 of this policy, due to no or low utilization, as follows:

Specialty
Procedure Code
Allergy and Immunology Specialty
89190
Cardiology and Interventional Cardiology Specialty
83880
Hematology Oncology and Medical Oncology Specialty
85007, 85008, 85009, 85013, 85014, 85027, 85032, 85044, 85048
Nephrology Specialty
81015, 81007
Orthopedic Surgery Specialty
89050, 89051, 89060
Reproductive Endocrinology Specialty
G0027
Rheumatology and Pediatric Rheumatology Specialty
83872, 85810, 89050, 89051, 89055
Urology Specialty
G0027, 81015, 81020, 87205, 81007

For more information, please view the following notifications that were published on April 21, 2023:


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