Who is affected by this change?

This affects Independence Blue Cross Vascular Surgery, OB-GYN, Radiology providers on Commercial plans.

When does this change take effect?

This change is effective Mar 5, 2025.

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CommercialCoverageLow impact

11.06.07e, Ovarian and Internal Iliac Vein Embolization as Treatment for Pelvic Congestion Syndrome

Independence Blue Cross·Vascular Surgery, OB-GYN, Radiology·Medical Policy

Effective date

Mar 5, 2025

We identified it

Jun 19, 2026

Days to comply

—

Summary

IBX has reissued their medical policy for ovarian and internal iliac vein embolization as treatment for pelvic congestion syndrome. This is a policy reissue that becomes effective March 5, 2025, affecting coverage determinations for this specialized interventional procedure.

Action Required

Action needed

By March 5, 2025: Review updated IBX policy 11.06.07e for ovarian and internal iliac vein embolization procedures. Verify current coverage criteria and documentation requirements for pelvic congestion syndrome treatments. Update prior authorization protocols if performing these procedures.

Related policy hubs

Independence Blue Cross policies Vascular Surgery OB-GYN Radiology