Medicare AdvantageAdministrativeLow impact
MA11.065d, Endometrial Ablation
Independence Blue Cross·NJ · OB-GYN, General Surgery·Medical Policy
We identified it
Jun 25, 2026
Summary
Independence Blue Cross reissued MA11.065d on 06/24/2026 to communicate the Company's continuing position on endometrial ablation coverage for Medicare Advantage members. The policy maintains existing coverage criteria, absolute contraindications, and medical necessity requirements with no substantive changes to billing, coding, or coverage rules.
Action Required
No immediate action required. This is a routine policy reissue with no changes to medical necessity criteria, contraindications, or billing requirements. Billing team should verify that current workflows already comply with existing coverage requirements: (1) endometrial ablation is covered only for premenopausal individuals with abnormal uterine bleeding, benign endometrium, who are unresponsive to or have contraindications to hormone therapy; (2) verify no absolute contraindications exist before processing claims (pregnancy, history of endometrial cancer, active infection, IUD in place, weak myometrium); (3) for microwave ablation specifically, confirm myometrial thickness ≥10 mm and uterine sounding length ≥6 cm; (4) ensure medical records documenting medical necessity are available upon request from the payer. File this reissued policy in reference materials for future audits.