Medicare AdvantageCoverageHigh impact
MA11.027e, Transcatheter Aortic Valve Replacement (TAVR) and Transcatheter Edge-to-Edge Repair (TEER) of the Mitral Valve
Independence Blue Cross·Cardiology, Cardiothoracic Surgery·Medical Policy
Effective date
Apr 2, 2025
We identified it
Jun 19, 2026
Summary
Policy MA11.027e has been reissued effective April 2, 2025, addressing coverage and billing requirements for Transcatheter Aortic Valve Replacement (TAVR) and Transcatheter Edge-to-Edge Repair (TEER) of the mitral valve procedures. The billing team must review the full policy text to identify specific code changes, prior authorization requirements, or documentation updates that may affect claim submission and reimbursement for these cardiac interventional procedures.
Action Required
By April 2, 2025: Billing team must obtain and review the complete policy text from the source URL to identify: (1) specific CPT codes for TAVR and TEER procedures, (2) any prior authorization requirements, (3) coverage limitations or exclusions, and (4) documentation requirements. Update billing system rules, encounter forms, and provider alerts accordingly. Contact the policy source (IBX) if specific codes are not clearly listed in the reissued policy. Failure to implement required changes may result in claim denials for TAVR and TEER procedures submitted after the effective date.