Medicare AdvantageCoverageMedium impact
MA07.034, 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 Medicare Advantage has issued a new medical policy (MA07.034) effective 01/01/2026 establishing coverage criteria for Laser Interstitial Thermal Therapy (LITT) in three neurological indications: refractory epilepsy, malignant brain tumors, and radiation necrosis. The policy requires multidisciplinary team approval, specific medical criteria, and MRI compatibility verification before LITT procedures can be covered.
Action Required
By December 31, 2025: (1) Billing team must update prior authorization system to require documentation of all LITT medical necessity criteria for CPT 61736 and 61737: proof of failed antiepileptic regimens (epilepsy), poor surgical candidacy status (brain tumors/radiation necrosis), absence of MRI contraindications, and multidisciplinary team approval from at least two specialists (neurosurgery plus neurology/oncology). (2) Providers must obtain and document multidisciplinary team consensus before submitting claims. (3) Update encounter templates and pre-auth checklists to capture these requirements. (4) Train billing staff to reject incomplete submissions lacking required documentation. Claims submitted without evidence of meeting all criteria will be denied by Independence Blue Cross Medicare Advantage plans.