Payor
Independence BCBS PA
Rubrica tracks 29 sourced coverage rules across 29 CPT codes for Independence BCBS PA — covering interventional spine, pain management, ortho spine, and orthopedics. Plan type(s): commercial. 3-state regional policy (sample: de, nj, pa).
Free with practitioner sign-in — magic-link email auth, no credit card.
Every Rubrica record cites a specific Independence BCBS PA policy document with last-reviewed date and (where available) verbatim source text. Aggregate coverage breakdown by procedure category is shown below; full payor-specific criteria require sign-in.
Coverage by category
Independence BCBS PA's coverage stance across procedure categories tracked in the Rubrica catalog.
| Category | Rules | Covered | Prior auth | Investigational |
|---|---|---|---|---|
| Other Procedure | 15 | 15 | 14 | 0 |
| Spine Surgery | 5 | 5 | 5 | 0 |
| Decompression | 3 | 1 | 3 | 2 |
| Arthroplasty — Hip | 1 | 1 | 1 | 0 |
| Arthroplasty — Knee | 1 | 1 | 1 | 0 |
| Arthroplasty — Shoulder | 1 | 1 | 1 | 0 |
| Arthroscopy — Knee | 1 | 1 | 1 | 0 |
| Arthroscopy — Shoulder | 1 | 1 | 1 | 0 |
| Diagnostic | 1 | 1 | 0 | 0 |
Top tracked procedures
First 15 CPT codes in the Independence BCBS PA catalog. Sign in for verbatim criteria, source links, and the rest of the catalog.
| CPT | Procedure | Coverage |
|---|---|---|
27447 | Total Knee Arthroplasty (TKA) | Covered |
27130 | Total Hip Arthroplasty (THA) | Covered |
23472 | Total Shoulder Arthroplasty (TSA / Reverse TSA) | Covered |
29827 | Arthroscopic Rotator Cuff Repair | Covered |
29888 | Arthroscopic ACL Reconstruction | Covered |
22551 | ACDF — Anterior Cervical Discectomy and Fusion | Covered |
22612 | PLF — Posterior Lumbar Fusion (Posterolateral) | Covered |
22558 | ALIF — Anterior Lumbar Interbody Fusion | Covered |
63030 | Laminotomy (Hemilaminectomy) with Disc Excision — Lumbar | Covered |
63047 | Laminectomy with Facetectomy and Foraminotomy — Lumbar | Covered |
62287 | Percutaneous Lumbar Decompression of Nucleus Pulposus (Decompressor / Coblation) | Not covered |
62380 | Endoscopic Decompression of Spinal Cord/Nerve Root — Lumbar (single interspace) | Not covered |
27446 | Unicompartmental Knee Arthroplasty (UKA) | Covered |
27487 | Revision Total Knee Arthroplasty — Femoral and Entire Tibial Component | Covered |
27486 | Revision Total Knee Arthroplasty — One Component | Covered |
27134 | Revision Total Hip Arthroplasty — Both Components | Covered |
29882 | Knee Arthroscopy with Meniscus Repair | Covered |
29848 | Endoscopic Carpal Tunnel Release | Covered |
23430 | Tenodesis of Long Tendon of Biceps | Covered |
24363 | Total Elbow Arthroplasty | Covered |
29805 | Diagnostic Shoulder Arthroscopy | Covered |
29881 | Knee Arthroscopy with Meniscectomy (Medial OR Lateral) | Covered |
29880 | Knee Arthroscopy with Meniscectomy (Medial AND Lateral) | Covered |
22630 | PLIF — Posterior Lumbar Interbody Fusion | Covered |
22633 | Combined Posterior + Posterolateral Interbody Fusion (lumbar) | Covered |
See every policy for Independence BCBS PA.
Sign in for verbatim coverage criteria, conservative-care requirements, source citations, and the denial-risk score for any clinical scenario.
Sign in — free for practitioners →