CommercialAdministrativeLow impact
11.11.01k, Evaluation and Treatment of Erectile Dysfunction (ED)
Independence Blue Cross·Urology, Internal Medicine, Family Medicine +1 more·Medical Policy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued Policy 11.11.01k on 01/21/2026 with no substantive changes to erectile dysfunction evaluation and treatment coverage. The policy continues to cover medically necessary diagnostic procedures, vacuum constriction devices, penile prosthetic implants, and penile revascularization under specific clinical criteria. CPT code 0864T was previously added on 01/02/2024 as part of a CPT code update.
Action Required
No immediate action required. This is a reissue with no changes to policy content or coverage criteria. Billing team should verify that CPT code 0864T (added 01/02/2024) is active in billing software and that all covered diagnostic and treatment codes listed remain properly configured in the system. If CPT 0864T has not been previously implemented, add it now with appropriate medical necessity edits requiring documented organic impotence and in-person clinical evaluation within six months.