CommercialCoverageMedium impact
Intracoronary Drug Delivery Balloon Procedures
Blue Cross & Blue Shield of Mississippi·Cardiology, Cardiothoracic Surgery·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 20, 2026
Summary
BCBS has classified all percutaneous coronary intervention with drug-coated balloons (DCB) for treating coronary in-stent restenosis as investigational, meaning these procedures will not be covered despite FDA approval of the AGENT Paclitaxel-Coated Balloon. Multiple CPT and ICD-10 codes are now flagged as investigational and claims will be denied.
Action Required
By April 1, 2026: Billing team must update system to flag CPT codes 0913T and 0914T, HCPCS code C9610, and all XW0J/XW0K/XW0L series ICD-10 codes as investigational/non-covered for BCBS plans. Notify cardiologists that drug-coated balloon procedures for in-stent restenosis will be denied by BCBS. Update pre-authorization system to automatically deny these codes.