Medicare AdvantageCoverageMedium impact
MA11.096b, Percutaneous Discectomy
Independence Blue Cross·NJ · Neurosurgery, Orthopedics, Pain Management·Medical Policy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross has reissued Medicare Advantage Policy MA11.096b (now superseded by MA11.096c as of 07/09/2025) confirming that percutaneous discectomy, including endoscopic approaches, remains classified as experimental/investigational and is NOT covered for Medicare Advantage beneficiaries. Despite FDA device approvals, IBX maintains its position that safety and effectiveness cannot be established from available literature. Billing teams must continue denying all claims for percutaneous discectomy procedures.
Action Required
Billing team must maintain existing denial protocols for all percutaneous discectomy claims (CPT 62330, 62331, 62380) submitted for Independence Blue Cross Medicare Advantage members. Ensure billing software, claim submission templates, and provider education materials reflect that these procedures are non-covered experimental/investigational services regardless of diagnosis code. Any claims received for these CPT codes should be denied immediately with reference to policy MA11.096c. No prior authorization process exists—these codes are categorically excluded from coverage.