CommercialPrior AuthHigh impact
11.02.27k, Percutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound (Independence)
Independence Blue Cross·Cardiology, Cardiothoracic Surgery, Vascular Surgery·Medical Policy
Effective date
Mar 24, 2025
We identified it
Jun 19, 2026
Summary
Policy 11.02.27k has been updated with changes to medical necessity criteria for percutaneous coronary intervention, coronary angiography, and arterial ultrasound procedures under Independence plans. The billing team must review and implement the new medical necessity requirements effective immediately to ensure claim authorization and payment compliance.
Action Required
By March 24, 2025: Billing and clinical teams must obtain and review the complete policy text for 11.02.27k from the provided URL to identify specific medical necessity criteria changes. Update prior authorization processes, clinical documentation requirements, and billing workflows to align with new criteria for CPT codes related to percutaneous coronary intervention, coronary angiography, and arterial ultrasound. Communicate updated requirements to providers and clinical staff. Implement changes in billing system and encounter forms. Monitor claims for compliance with new criteria. Failure to meet new medical necessity standards will result in claim denials.