CommercialAdministrativeLow impact
11.16.09, Bronchial Valves
Independence Blue Cross·Pulmonology, Critical Care, Cardiothoracic Surgery·Medical Policy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued Policy 11.16.09 on 07/08/2026 to communicate the company's continuing position on bronchial valve coverage. No substantive coverage criteria changes were made; this is a routine reissue confirming existing medical necessity requirements for FDA-approved bronchial valve devices (Zephyr, Spiration) in severe emphysema treatment and IBV valve coverage for post-surgical air leaks.
Action Required
No immediate action required. This is a policy reissue confirming existing coverage criteria with no substantive changes. Billing team should verify current system configuration aligns with the nine medical necessity criteria for bronchial valve placement (age 40-75, BMI <35, FEV1 15-45%, prior pulmonary rehab, smoking abstinence ≥4 months, etc.) and that prior authorization workflows remain in place. File updated policy document for compliance records.