Medicare AdvantageAdministrativeLow impact
MA11.020, Bronchial Valves
Independence Blue Cross·NJ · Pulmonology, Critical Care, Cardiothoracic Surgery·Medical Policy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued MA11.020 on 07/08/2026 to communicate the company's continuing position on bronchial valves for Medicare Advantage members. The policy maintains existing coverage criteria for FDA-approved bronchial valve placement (Zephyr® or Spiration® Valve System) in severe emphysema treatment, with no substantive changes to medical necessity requirements, billing codes, or reimbursement parameters.
Action Required
No immediate action required. This is a reissue for policy continuity with no substantive changes. Billing team should verify current system templates reflect the nine medical necessity criteria for bronchial valve coverage (age 40-75, BMI <35, FEV1 15-45%, etc.) and confirm prior authorization processes require documentation of all criteria before claim submission. No workflow changes or code updates are needed at this time.