When does this change take effect?

This change is effective Mar 5, 2025.

CommercialCoverageMedium impact

11.03.01f, Repair of Cleft Lip, Cleft Nose, and/or Cleft Palate

Q: Who is affected by this change?

This affects Independence Blue Cross Plastic Surgery, Oral & Maxillofacial Surgery, ENT (Ear, Nose & Throat), Pediatrics providers on Commercial plans.

Independence Blue Cross·Plastic Surgery, Oral & Maxillofacial Surgery, ENT (Ear, Nose & Throat) +1 more·Medical Policy

Effective date

Mar 5, 2025

We identified it

Jun 19, 2026

Days to comply

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Summary

Commercial policy 11.03.01f for Repair of Cleft Lip, Cleft Nose, and/or Cleft Palate has been reissued with updates effective March 5, 2025. This is a fresh policy update that may contain changes to coverage criteria, billing requirements, or documentation standards for cleft-related surgical procedures.

Action Required

Action needed

By March 5, 2025: Billing team must review the updated policy 11.03.01f for cleft lip/palate repairs at the source URL to identify specific changes to coverage criteria, prior authorization requirements, or documentation standards. Update billing protocols and inform providers of any new requirements for cleft-related procedures.

Related policy hubs

Independence Blue Cross policies Plastic Surgery Oral & Maxillofacial Surgery ENT (Ear, Nose & Throat)Pediatrics