CommercialCoverageMedium impact
PAP260 - Implantable Device Audit and Billing Procedure - Updated language to include MP 9.01.502
Blue Cross of Idaho·ID · Orthopedics, General Surgery, Cardiothoracic Surgery +7 more·Reimbursement
Effective date
Nov 1, 2025
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho updated their implantable device billing policy (PAP260) to reference Medical Policy MP 9.01.502, which states that any supply or implant that is not FDA-approved will be considered investigational and will not be covered. This affects billing for implantable devices coded with L8699, C1889, or other unspecified implant codes at ambulatory surgery centers and outpatient facilities.
Action Required
Immediately: Billing team must verify FDA approval status for all implantable devices before billing with codes L8699, C1889, or other unspecified implant codes. Update billing procedures to flag non-FDA-approved supplies/implants as they will be denied as investigational per MP 9.01.502. For ASCs, ensure invoices are maintained for devices over $100 and can be provided within 30 days if audited by Blue Cross of Idaho.