CommercialCoverageMedium impact
11.08.15ac, Reconstructive Breast Surgery and Post-Mastectomy Prostheses
Independence Blue Cross·Plastic Surgery, General Surgery, Oncology·Medical Policy
Effective date
May 28, 2025
We identified it
Jun 19, 2026
Summary
This is a reissue of policy 11.08.15ac covering Reconstructive Breast Surgery and Post-Mastectomy Prostheses for commercial plans. The policy was reposted with an effective date of 05/28/2025, but no specific changes are detailed in the summary provided.
Action Required
By May 28, 2025: Billing team should review the full policy document at the provided URL to identify specific changes to coverage criteria, billing requirements, or prior authorization rules for reconstructive breast surgery and post-mastectomy prostheses. Update billing procedures and encounter forms accordingly once changes are identified.