Effective May 18, 2020, Independence will no longer reimburse dermatology providers for performing certain pathology in the office setting. This applies to providers in the Independence five-county service area (i.e., Bucks, Chester, Delaware, Montgomery, and Philadelphia counties) and contiguous counties (i.e., counties that border the Independence five-county service area).

Policy update

CPT^®​ procedure codes have been updated to reflect the changes in the PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services policy.

The affected CPT procedure codes are:

A Notification was posted to the Independence Medical Policy Portalon February 14, 2020, to address the changes in policies:

• Commercial: #00.01.25aw: PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
• Medicare Advantage: #MA00.010y: PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services

Learn more

To view the Notifications for these policies, visit our Medical Policy Portal. If you have any questions about this change, please email our Provider Network Services team at pnsproviderrequests@ibx.com.

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