CommercialCoverageMedium impact
11.02.16u, Ventricular Assist Devices (VADs)
Independence Blue Cross·PA · Cardiology, Cardiothoracic Surgery, Critical Care +2 more·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued VAD policy 11.02.16u on 04/01/2026 to communicate the company's continuing position on ventricular assist devices. The policy criteria for percutaneous VADs (pVADs) were revised to reflect updated FDA labeling for the Impella® RP System and final post-approval study (PAS) results. The guidelines section was also updated to incorporate the FDA's updated labeling for the Impella® RP System.
Action Required
By 04/01/2026: Billing team must review and update system documentation to reflect the revised pVAD coverage criteria for Impella® RP System based on updated FDA labeling and PAS results. Verify that all VAD procedure claims (CPT 33975, 33976, 33977, 33978, 33979, 33980, 33981, 33982) and component claims (HCPCS Q0477–Q0481) are submitted with appropriate documentation supporting FDA-labeled indication and medical necessity per the updated criteria. Providers should confirm facility VAD certification status (Joint Commission, Medicare-approved heart transplant facility, or UNOS-approved program) before billing. Update internal medical necessity templates and prior authorization guidelines if applicable to reflect the Impella® RP changes. Failure to align with the revised criteria may result in claim denials.