Medicare AdvantageBilling CodesMedium impact
MA05.027e, Implantable Cardioverter Defibrillators
Independence Blue Cross·Cardiology, Cardiothoracic Surgery, Critical Care +1 more·Medical Policy
Effective date
Oct 20, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross Medicare Advantage updated policy MA05.027e to MA05.027f, expanding ICD coverage criteria to address transvenous, subcutaneous, and extravascular implantable cardioverter defibrillators. New CPT codes (0571T-0574T) were added for substernal electrode procedures, and applicable HCPCS codes (C7537, C7538) were incorporated. The policy reissued on 04/01/2026 communicates the company's continuing position with no substantive coverage criteria changes from the previous version.
Action Required
By 10/20/2025: Billing team must update billing system to recognize and properly code new CPT codes 0571T, 0572T, 0573T, and 0574T for substernal ICD electrode procedures. Ensure HCPCS codes C7537 and C7538 are active in the system for dual-chamber upgrades performed at time of ICD insertion. Verify that prior authorization workflows reference the updated policy MA05.027f (not MA05.027e, which has been superseded). Update encounter templates and provider documentation guidelines to reflect coverage for transvenous, subcutaneous, and extravascular ICD options. Train billing staff on distinction between device types and appropriate code assignment. Failure to update coding will result in claim denials for the new substernal ICD procedure codes.