Medicare AdvantageBilling CodesHigh impact
MA11.019n, Vagus Nerve Stimulation (VNS)
Independence Blue Cross·Neurology, Neurosurgery, General Surgery +1 more·Medical Policy
Effective date
Oct 1, 2026
We identified it
Oct 2, 2026
Summary
Independence Blue Cross Medicare Advantage has added four new CPT codes (1057T, 1058T, 1059T, 1060T, 1061T) to policy MA11.019n effective 10/01/2026, classified as Experimental/Investigational for vagus nerve stimulation. These codes are NOT covered and should not be billed to Medicare Advantage plans. The policy maintains coverage only for medically refractory seizures under specific criteria.
Action Required
By 09/30/2026: Billing team must update billing system to block claims for CPT codes 1057T, 1058T, 1059T, 1060T, and 1061T when submitted to Independence Blue Cross Medicare Advantage plans, marking them as non-covered (Experimental/Investigational). Update denial reason codes to reference MA11.019n. Providers must be notified via billing guidelines and encounter form updates that these codes cannot be billed to Medicare Advantage. Claims submitted with these codes will be denied. For covered VNS procedures (CPT 0908T, 0909T, 0910T, 0911T, 0912T), ensure medical necessity documentation confirms medically refractory seizures and that surgery is not recommended or has failed. Contact Independence Blue Cross if questions arise about code applicability to specific indications.