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Independence Blue CrossMedicare Advantage · Coverage · Medical Policy · Cardiology, Internal Medicine, NephrologyMedium impact

MA11.120, Renal Denervation for Uncontrolled Hypertension

Act
by Oct 28, 2025, the billing team must
Effective date
Oct 28, 2025
Identified
Jun 19, 2026

Summary

Independence Blue Cross has issued a new Medicare Advantage policy (MA11.120a) establishing that renal denervation for uncontrolled hypertension is experimental/investigational and NOT covered, except under Medicare's Coverage with Evidence Development (CED) program for patients enrolled in CMS-approved clinical trials. Billing teams must use Modifier Q0 with specific CPT and HCPCS codes to identify CED-eligible claims, and only services meeting all CED requirements will be reimbursed.

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What to do

by Oct 28, 2025, the billing team must · 5 steps
01Update billing software to require Modifier Q0 when submitting claims for CPT codes 0338T, 0339T, 0935T and HCPCS codes C1735, C1736 for renal denervation procedures.
02Verify patient enrollment in a CMS-approved CED clinical trial BEFORE claim submission—claims without CED approval will be denied as experimental/investigational.
03Implement a pre-billing verification checklist requiring documentation that all CMS NCD (20.40) requirements are met, including use of approved devices and clinical trial enrollment.
04Train providers and billing staff that routine renal denervation claims without CED enrollment will be rejected.
05Ensure medical records include all required documentation (office records, hospital records, test reports) and make available to Independence Blue Cross upon audit request.
If missed: Failure to include Modifier Q0 or verify CED eligibility will result in claim denials.

Codes mentioned

C1735C1736Z00.6

Original notice

MA11.120, Renal Denervation for Uncontrolled Hypertension
medpolicy.ibx.com · Always check the source before changing claims.
View original ↗

Related changes

See all Independence Blue Cross changes →
MA11.120a, Renal Denervation for Uncontrolled HypertensionMediumEffective Apr 1, 2026 · Medical Policy11.02.29, Renal Denervation for Uncontrolled HypertensionMediumEffective Jan 1, 2026 · Medical Policy11.02.29a, Renal Denervation for Uncontrolled HypertensionMediumEffective Apr 1, 2026 · Medical PolicyMA05.067f, Leadless PacemakersLowEffective Jul 1, 2024 · Medical PolicyBrowse every Independence Blue Cross change in the policy list

Related policy hubs

Independence Blue Cross policiesCardiologyInternal MedicineNephrologyCode C1735Code C1736Code Z00.6

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