CommercialCoverageMedium impact
11.02.26c, Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation
Independence Blue Cross·Cardiology, Cardiothoracic Surgery·Medical Policy
Effective date
Apr 2, 2025
We identified it
Jun 19, 2026
Summary
Policy 11.02.26c addresses coverage and medical necessity criteria for percutaneous left atrial appendage (LAA) closure devices used for stroke prevention in atrial fibrillation patients. This reissue (effective 04/02/2025) establishes or updates guidelines for when these devices are considered medically necessary and covered by the plan. Billing teams must verify patient eligibility, medical documentation, and prior authorization requirements before submitting claims for LAA closure procedures.
Action Required
By 04/02/2025: Billing team must review the full policy text at the provided URL to identify specific CPT/HCPCS codes for LAA closure devices and any prior authorization requirements. Update billing system to enforce any new medical necessity criteria and prior auth workflows. Providers should be notified of updated documentation requirements for LAA closure cases. Before submitting claims for LAA closure procedures, verify that patient meets medical necessity criteria outlined in policy 11.02.26c. Failure to obtain required prior authorization or missing medical documentation will result in claim denials.