CommercialBilling CodesMedium impact
11.00.16k, Ablation of Lung Tumors
Independence Blue Cross·Cardiothoracic Surgery, Pulmonology, Oncology +1 more·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued Policy 11.00.16k on lung tumor ablation with minor updates effective 01/01/2026, including a CPT code narrative revision for code 0600T and termination of HCPCS code C9751. The policy maintains coverage for radiofrequency ablation, cryosurgical ablation, and microwave ablation under specified medical necessity criteria, while pulsed electric field ablation remains experimental/investigational.
Action Required
By 01/01/2026, billing team must: (1) Update billing system to discontinue use of HCPCS code C9751, which has been terminated; (2) Verify CPT code 0600T billing descriptions match the revised narrative in the system; (3) Confirm that CPT codes 31641, 32994, and 32998 are configured as medically necessary and do not require prior authorization when medical necessity criteria are met; (4) Do not bill HCPCS code C8005 (pulsed electric field ablation) as it remains experimental/investigational and will be denied; (5) Review encounter templates and prior authorization workflows to ensure thoracic surgeon evaluation documentation is collected for all ablation requests per policy requirements; (6) Train billing and coding staff on the three covered ablation methods (RFA, cryosurgical, microwave) and their distinct medical necessity criteria. Failure to discontinue C9751 will result in claim denials.