CommercialCoverageMedium impact
11.15.01y, Spinal Cord Ganglion and Dorsal Root Ganglion Stimulation (Independence Administrators)
Independence Blue Cross·Neurosurgery, Pain Management, PM&R (Physical Medicine & Rehab)·Medical Policy
Effective date
May 14, 2025
We identified it
Jun 19, 2026
Summary
Independence Administrators has reissued policy 11.15.01y regarding coverage and billing for Spinal Cord Ganglion and Dorsal Root Ganglion Stimulation procedures, effective May 14, 2025. The billing team must review this reissued policy to identify any changes to prior authorization requirements, covered codes, medical necessity criteria, or reimbursement rates that may affect claim submission and processing.
Action Required
By May 14, 2025: Billing team must obtain and review the full text of policy 11.15.01y from Independence Administrators to identify specific CPT codes, HCPCS codes, prior authorization requirements, and medical necessity documentation standards for spinal cord ganglion and dorsal root ganglion stimulation procedures. Update billing system rules, prior authorization workflows, and provider documentation templates accordingly. Flag this policy for all staff submitting claims to Independence Administrators to ensure compliance. Without this update, claims for these procedures may be denied or delayed.