Medicare AdvantageCoverageMedium impact
MA07.034, Laser Interstitial Thermal Therapy (LITT)
Independence Blue Cross·Neurosurgery, Neurology, Oncology +1 more·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross has reissued MA07.034 to communicate its continuing Medicare Advantage coverage position for Laser Interstitial Thermal Therapy (LITT). The policy establishes medical necessity criteria for three indications: refractory epilepsy, malignant brain tumors, and radiation necrosis. All LITT procedures require multidisciplinary team agreement, MRI compatibility, and documented medical necessity before coverage is granted.
Action Required
By January 1, 2026: Billing team must implement prior authorization requirements for CPT 61736 and 61737 in the billing system for Independence Blue Cross Medicare Advantage patients. Establish workflow to verify that all three medical necessity criteria are documented before claim submission: (1) patient history confirming treatment failure per policy, (2) imaging documentation of lesion accessibility, and (3) multidisciplinary team sign-off from at least two specialists. Update encounter templates and submission checklists to include MRI contraindication verification. Create denial management protocols for claims missing required documentation, as these will be denied without medical necessity evidence. Train providers and billing staff on the three covered indications (refractory epilepsy, malignant brain tumors, radiation necrosis) to distinguish from non-covered uses. Flag any LITT requests that do not meet all stated criteria for prior authorization denial before claim submission to reduce rejections.