Medicare AdvantageBilling CodesHigh impact
MA05.027e, Implantable Cardioverter Defibrillators
Independence Blue Cross·Cardiology, Cardiothoracic Surgery, Critical Care·Medical Policy
Effective date
Oct 20, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated MA05.027e to MA05.027f effective 10/20/2025, expanding ICD coverage criteria to include transvenous, subcutaneous, and extravascular implantable cardioverter defibrillators. New CPT codes (0571T, 0572T, 0573T, 0574T) and HCPCS codes (C7537, C7538) were added to support these device types. The policy was reissued on 04/01/2026 to reaffirm the Company's position with no substantive coverage changes.
Action Required
By 10/20/2025: Billing team must update billing software and encounter forms to recognize and process new CPT codes 0571T, 0572T, 0573T, 0574T and HCPCS codes C7537, C7538 for subcutaneous and extravascular ICD procedures. Verify that claims submission workflows support these codes and that providers understand when to use each code based on device type (transvenous vs. subcutaneous vs. extravascular). Update medical necessity documentation requirements to align with expanded criteria covering all three ICD types. Train clinical and billing staff on the new device technologies and applicable coding. Failure to implement these codes may result in claim rejections or incorrect reimbursement for ICD implantations performed on or after the effective date.