CommercialAdministrativeLow impact
11.02.25j, Transcatheter Cardiac Valve Procedures
Independence Blue Cross·Cardiology, Cardiothoracic Surgery, Internal Medicine·Medical Policy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued policy 11.02.25k for Transcatheter Cardiac Valve Procedures, maintaining the company's continuing position on TAVR coverage. The policy was updated to include new ICD-10 code Q23.88 (Other congenital malformations of aortic and mitral valves) effective 10/01/2024. No substantive changes to medical necessity criteria, coverage requirements, or billing codes occurred in the most recent 04/01/2026 reissuance.
Action Required
No immediate action required. This is a policy reissuance confirming IBX's continuing position on TAVR coverage with no substantive changes to medical necessity criteria. Billing and clinical teams should verify they are referencing policy 11.02.25k (not superseded version 11.02.25j) in their systems. Ensure ICD-10 code Q23.88 is available in billing software if coding for congenital aortic/mitral valve malformations. Verify that TAVR procedures continue to meet all five documented medical necessity criteria before submission: severe aortic stenosis with calcified annulus, NYHA Class II-IV symptoms, absence of unicuspid/bicuspid valves, credentialed provider, and credentialed facility.