Medicare AdvantageCoverageMedium impact
MA11.101, Nucleoplasty
Independence Blue Cross·Neurosurgery, Orthopedics, Pain Management +1 more·Medical Policy
Effective date
Jan 21, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross has reissued MA11.101 effective 01/21/2026, reaffirming that nucleoplasty for intervertebral disc decompression in the lumbar, thoracic, or cervical spine remains experimental/investigational and is NOT covered under Medicare Advantage plans. Despite FDA approval of devices, the company determined insufficient peer-reviewed evidence supports safety and effectiveness. Billing teams must continue denying all nucleoplasty claims and reject any associated bills.
Action Required
By 01/21/2026: Billing team must ensure claims systems and billing software continue to deny all nucleoplasty procedures billed under CPT 22899 (thoracic/cervical spine) and HCPCS S2348 (lumbar spine) for Independence Blue Cross Medicare Advantage members. Verify that automated claim scrubbing rules are active to block these codes at submission. Educate providers that nucleoplasty is non-covered experimental/investigational and will not be reimbursed. Post-denial, advise members of non-coverage status and that they may be responsible for out-of-pocket costs if they choose to proceed. Document all denials with reference to policy MA11.101 effective 01/21/2026.