Medicare AdvantageAdministrativeLow impact
MA11.065d, Endometrial Ablation
Independence Blue Cross·NJ · OB-GYN, General Surgery·Medical Policy
Effective date
Jun 24, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued MA11.065d on 06/24/2026 to communicate the Company's continuing position on endometrial ablation coverage for Medicare Advantage members. The policy maintains existing medical necessity criteria, absolute contraindications, and FDA-approved device requirements with no substantive changes to coverage or billing guidance.
Action Required
No immediate action required. This is a routine policy reissue with no substantive changes. Billing team should confirm that current procedures for endometrial ablation claims continue to comply with existing medical necessity criteria (abnormal uterine bleeding, benign endometrium, failure of hormone therapy, hysterectomy candidacy) and absolute contraindications documentation. Verify that all claims for CPT 58353, 58356, and 58563 include proper pre-procedure documentation ruling out thyroid disease, coagulopathy, fibroids, polyps, and malignancy before processing. No changes to prior authorization processes, coding, or reimbursement rates are required.