Medicare AdvantageBilling CodesHigh impact
MA11.056i, Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery
Independence Blue Cross·PA · Vascular Surgery, Cardiothoracic Surgery, Cardiology +3 more·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross MA11.056i policy on Percutaneous Transluminal Angioplasty (PTA) with carotid stenting has been reissued with annual updates to CPT/HCPCS codes effective January 1, 2026. Seven CPT codes were revised, five new codes were added (37254-37261, 37263-37278, 37280-37299, 92930, 92945), and seven codes were terminated (37220-37235, 92921, 92925, 92929, 92934, 92938, 92944). Coverage criteria remain unchanged but billing teams must update systems to reflect these code transitions.
Action Required
By December 31, 2025: Billing team must update all billing software and claim submission systems to implement the following CPT code changes for Independence Blue Cross Medicare Advantage (MA) plans: (1) REMOVE terminated codes 37220-37235, 92921, 92925, 92929, 92934, 92938, 92944 from billing systems and ensure no new claims are submitted with these codes; (2) ADD new codes 37254-37261, 37263-37278, 37280-37299, 92930, 92945 to billing systems with proper coverage indicators; (3) UPDATE narratives for revised codes 92920, 92924, 92928, 92933, 92937, 92941, 92943 in fee schedules and claim templates; (4) ALERT providers and clinical staff that PTA with carotid stenting procedures must use updated codes starting January 1, 2026; (5) ESTABLISH claim edits to reject any claims submitted with terminated codes after the effective date. Failure to implement these changes will result in claim denials and delayed reimbursement for vascular surgery procedures.