Medicare AdvantageAdministrativeLow impact
MA11.079e, Evaluation and Treatment of Erectile Dysfunction (ED)
Independence Blue Cross·NJ · Urology, Internal Medicine, Family Medicine·Medical Policy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued MA11.079e on 01/21/2026 to communicate the Company's continuing position on ED evaluation and treatment. The policy adds CPT code 0864T (effective 01/02/2024) and now applies to New Jersey Medicare Advantage lines of business (effective 01/01/2024). No substantive coverage criteria changes were made in the most recent reissuance.
Action Required
No immediate action required. This is a reissuance of existing policy with no substantive changes to coverage criteria or billing instructions. Billing teams should confirm that CPT code 0864T (added 01/02/2024) is already configured in billing systems for medically necessary ED evaluation procedures. Verify that L7900 and L7902 (vacuum erection device codes) remain marked as NOT COVERED in system rules to prevent inappropriate claims submission. For New Jersey Medicare Advantage plans specifically: confirm that this policy is effective 01/01/2024 and properly applied in plan-specific billing configurations.