Medicare AdvantageCoverageMedium impact
MA11.097e, Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis
Independence Blue Cross·Neurosurgery, Pain Management, Orthopedics·Medical Policy
Effective date
Apr 2, 2025
We identified it
Jun 19, 2026
Summary
Policy MA11.097e regarding Percutaneous Image-Guided Lumbar Decompression (PILD) for Spinal Stenosis has been reissued effective 04/02/2025. This is a Medicare Advantage policy change that billing teams must review for any updates to coverage criteria, prior authorization requirements, or billing code specifications for this minimally invasive spinal procedure.
Action Required
By 04/02/2025: Billing team must obtain and review the complete policy text from the provided URL to identify specific coverage requirements, prior authorization mandates, and any billing code changes for PILD procedures. Update billing system rules, prior authorization templates, and provider documentation requirements accordingly. Ensure all claims for PILD procedures on Medicare Advantage plans comply with the reissued policy criteria. Failure to implement policy requirements may result in claim denials or payment recouptures.