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MA11.112, Composite Tissue Allotransplantation of the Hand(s) and Face

Independence Blue Cross·Transplant Surgery, Plastic Surgery·Medical Policy
Effective date
Aug 6, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

Policy MA11.112 regarding Composite Tissue Allotransplantation of the Hand(s) and Face was reissued effective 08/06/2025. This is a specialized transplant procedure policy that billing teams must review for coverage criteria, prior authorization requirements, and applicable billing codes to ensure compliant claim submission for Medicare Advantage members.

Action Required

Action needed
By 08/06/2025: Billing team must obtain and review the full policy text from the provided source URL to identify: (1) specific CPT/HCPCS codes for composite tissue allotransplantation procedures, (2) prior authorization requirements and submission process, (3) medical necessity documentation requirements, and (4) any coverage limitations. Update billing system rules and provider notification templates accordingly. Ensure all claims for hand and face composite tissue allotransplantation procedures submitted on or after the effective date comply with updated requirements. Failure to follow updated policy guidelines will result in claim denials.