Medicare AdvantageCoverageMedium impact
MA11.120, Renal Denervation for Uncontrolled Hypertension
Independence Blue Cross·Cardiology, Internal Medicine, Nephrology·Medical Policy
Effective date
Oct 28, 2025
We identified it
Jun 19, 2026
Summary
MA11.120 is a new Medicare Advantage policy establishing coverage criteria for renal denervation procedures in patients with uncontrolled hypertension. This is the first policy guidance on this procedure; billing teams must understand coverage requirements, prior authorization mandates, and any specific coding or documentation requirements before submitting claims.
Action Required
By 2025-10-28: Billing team must obtain and review the full MA11.120 policy text to identify: (1) specific CPT/HCPCS codes for renal denervation procedures, (2) prior authorization requirements and process, (3) medical necessity criteria and required documentation, (4) any excluded diagnoses or patient populations. Update billing software to flag renal denervation claims for prior authorization review. Notify providers of coverage criteria and documentation requirements. Contact plan at https://medpolicy.ibx.com/ibc/ma/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=01&FilterField2=MPSiteActivityLogYear&FilterValue2=2026#medicare-advantage-ma11-120-renal-denervation-for-uncontroll for complete policy details. Claims submitted without proper prior authorization or documentation will be denied.