Medicare AdvantageAdministrativeLow impact
MA11.039e, Cochlear Implantation
Independence Blue Cross·NJ · Audiology, ENT (Ear, Nose & Throat)·Medical Policy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued MA11.039e on 05/27/2026 with no substantive changes to cochlear implantation coverage criteria. The policy maintains existing coverage for bilateral moderate-to-profound sensorineural hearing loss meeting specific audiological and medical criteria, and continues to exclude unilateral hearing loss and assistive listening devices as experimental/investigational or non-covered. Billing teams should verify their system reflects the current policy version (05/27/2026) to ensure compliance.
Action Required
No immediate action required. This is a reissue with no changes to medical necessity criteria, coverage rules, or billing codes. Billing team should confirm that billing system reflects policy version MA11.039e (effective 01/01/2024, reissued 05/27/2026) and that all covered codes (CPT 69930, 92601-92604, 92626; HCPCS L8614-L8621) and diagnosis codes (H90.3, H90.6) continue to be processed per existing guidelines. Verify that unilateral hearing loss diagnosis codes (H90.A11, H90.A12, H90.11, H90.12) remain marked as experimental/investigational and are not approved for coverage.