CommercialAdministrativeLow impact
11.06.05f, Endometrial Ablation
Independence Blue Cross·OB-GYN, General Surgery·Medical Policy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued its Endometrial Ablation policy (11.06.05f) on 06/24/2026 to communicate the company's continuing position. This is a routine reissue with no substantive changes to coverage criteria, contraindications, or billing codes. The policy maintains coverage for endometrial ablation in premenopausal individuals with abnormal uterine bleeding who are unresponsive to hormone therapy, subject to documented medical necessity and absolute contraindications.
Action Required
No immediate action required. This is a routine policy reissue with no substantive changes. Billing team should verify that current claim processing for endometrial ablation (CPT 58353, 58356, 58563) continues to follow the existing medical necessity criteria: patient must be premenopausal with benign endometrium, unresponsive to hormone therapy or have contraindications to it, and be a candidate for hysterectomy. Continue to deny claims when absolute contraindications are present (pregnancy intent, endometrial cancer history, active infection, IUD in place, myometrial weakness, or for microwave ablation: Essure presence, myometrial thickness <10mm, or uterine sounding length <6cm). Ensure all claims include documentation of medical necessity in the patient record or risk denial.