CommercialCoverageMedium impact
11.08.19s, Prophylactic Mastectomy, Oophorectomy/Salpingo-Oophorectomy, and Hysterectomy
Independence Blue Cross·OB-GYN, General Surgery, Plastic Surgery +1 more·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
This is a reissue of the existing policy covering prophylactic mastectomy, oophorectomy/salpingo-oophorectomy, and hysterectomy procedures for commercial plans. The policy was reposted with an effective date of April 1, 2026, but no specific changes to coverage criteria or billing requirements are detailed in the provided information.
Action Required
By March 31, 2026: Billing team should review the full policy text at the provided URL to identify any changes to coverage criteria, prior authorization requirements, or documentation standards for prophylactic mastectomy, oophorectomy/salpingo-oophorectomy, and hysterectomy procedures. Update billing protocols and staff training as needed based on policy review.