CommercialCoverageMedium impact
07.03.28, Laser Interstitial Thermal Therapy (LITT)
Independence Blue Cross·Neurosurgery, Neurology, Oncology +1 more·Medical Policy
Effective date
Jan 1, 2026
We identified it
Sep 3, 2026
Summary
Independence Blue Cross has reissued its LITT policy (effective 01/01/2026) establishing coverage criteria for laser interstitial thermal therapy in three specific indications: refractory epilepsy, malignant brain tumors, and radiation necrosis. All other uses remain experimental/investigational and non-covered. Billing teams must verify multidisciplinary team approval and MRI compatibility documentation before processing claims for CPT 61736 or 61737.
Action Required
By 01/01/2026: Billing team must implement coverage criteria verification for LITT claims submitted under CPT 61736 or 61737. Before claim submission, verify documentation includes: (1) for refractory epilepsy—evidence of failure on ≥2 antiepileptic drug regimens; (2) for malignant brain tumors or radiation necrosis—documentation that patient is a poor surgical candidate; (3) for all indications—MRI contraindication screening results and multidisciplinary team approval (minimum 2 specialists). Update pre-authorization templates and billing software to require these documentation elements. Set system rules to deny claims for any LITT indication outside the three covered categories (route to experimental/investigational denial code). Train providers and coders that any LITT use not meeting these criteria will not be reimbursed per plan exclusion.