CommercialBilling CodesMedium impact
11.17.06u, Surgical and Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)
Independence Blue Cross·PA · Urology·Medical Policy
Effective date
Jul 1, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated policy 11.17.06u to 11.17.06x effective July 1, 2025, adding CPT code 0950T and removing CPT code 53899 for surgical and minimally invasive BPH treatments. Billing teams must update systems to recognize the new code and discontinue use of the removed code to prevent claim denials.
Action Required
By July 1, 2025: Billing team must update all billing systems, fee schedules, and claim submission software to add CPT code 0950T as a covered/medically necessary code for BPH surgical and minimally invasive treatments under policy 11.17.06x. Simultaneously, remove CPT code 53899 from all active billing rules and templates to prevent accidental billing. Update provider documentation templates and prior authorization workflows to reflect the code change. Verify that claims using 53899 submitted after July 1, 2025 will be rejected or require correction. Communicate the change to all providers performing BPH procedures. Failure to implement these changes will result in claim denials for procedures billed with the outdated or incorrect codes.