Medicare AdvantageBilling CodesMedium impact
MA11.117a, Peroral Endoscopic Myotomy (POEM) Procedures
Independence Blue Cross·Gastroenterology, General Surgery·Medical Policy
Effective date
Jan 5, 2026
We identified it
Jun 19, 2026
Summary
Policy MA11.117a establishes medical coding guidance for Peroral Endoscopic Myotomy (POEM) procedures under Medicare Advantage plans. This recent policy (1 month old) provides updated billing and coding requirements for this advanced endoscopic treatment. The billing team must review and implement any new coding rules or documentation requirements outlined in the full policy text.
Action Required
By January 5, 2026: Billing team must obtain and review the full MA11.117a policy text from the source URL to identify specific CPT, HCPCS, or ICD-10 codes affected by this medical coding change. Update billing software, encounter forms, and provider documentation templates accordingly. Communicate any new prior authorization, coding, or documentation requirements to clinical staff. Verify that all POEM procedure claims submitted after the effective date comply with the new coding guidelines to avoid denials.