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MA11.121, Intraosseous Basivertebral Nerve Ablation
Act
by Sep 15, 2026
Effective date
Oct 1, 2026
Identified
Oct 2, 2026
Summary
Independence Blue Cross has published a new Medicare Advantage policy (MA11.121) effective October 1, 2026, that classifies intraosseous basivertebral nerve ablation (Intracept system) as experimental/investigational and NOT COVERED for all indications including vertebrogenic back pain. This replaces previous guidance in the Experimental/Investigational Services policy (MA00.005). Billing teams must deny all claims for CPT codes 64628 and 64629 under Medicare Advantage plans.
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What to do
by Sep 15, 2026 · 5 steps
01Billing team must update billing software and denial protocols to automatically deny all claims for CPT 64628 and CPT 64629 when submitted under Independence Blue Cross Medicare Advantage plans.
02Update claim submission rules to reject these codes at point-of-entry.
03Communicate to all providers performing spine procedures that intraosseous basivertebral nerve ablation is not a covered benefit and cannot be billed to Medicare Advantage members.
04Add these codes to the internal non-covered services list.
05Any claims submitted after October 1, 2026 for these procedures will be denied with reference to policy MA11.121, and members cannot be balance-billed as this is a plan exclusion for experimental/investigational services.
Codes mentioned
6462864629
Original notice
MA11.121, Intraosseous Basivertebral Nerve Ablation
medpolicy.ibx.com · Always check the source before changing claims.