Medicare AdvantageCoverageMedium impact
MA11.030i, Reconstructive Breast Surgery
Independence Blue Cross·Plastic Surgery, General Surgery, Oncology·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA11.030i for Reconstructive Breast Surgery has been updated with changes effective January 1, 2026. This is a very recent policy update that may affect coverage criteria, prior authorization requirements, or documentation standards for breast reconstruction procedures under Medicare Advantage plans.
Action Required
Before January 1, 2026: Billing team and providers must review the updated MA11.030i Reconstructive Breast Surgery policy at the provided URL to identify specific changes to coverage criteria, prior authorization requirements, or documentation standards. Update billing workflows, prior authorization processes, and provider documentation templates accordingly for all Medicare Advantage breast reconstruction cases.