Medicare AdvantageCoverageMedium impact
MA11.066c, Ovarian and Internal Iliac Vein Embolization as Treatment for Pelvic Congestion Syndrome
Independence Blue Cross·Vascular Surgery, Radiology, OB-GYN·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Policy MA11.066c provides updated guidance on ovarian and internal iliac vein embolization as a treatment option for pelvic congestion syndrome effective January 1, 2025. This is an informational/guideline update that clarifies coverage criteria and clinical requirements for this interventional procedure on Medicare Advantage plans.
Action Required
By January 31, 2025: Billing and clinical teams must review the full policy text at the provided URL to understand coverage requirements, medical necessity criteria, and any prior authorization mandates for ovarian and internal iliac vein embolization procedures. Update internal procedures and provider guidelines accordingly. Ensure providers document medical necessity according to the policy guidelines. If prior authorization is required, update billing software workflows to enforce this requirement before submitting claims. Contact the payer directly if specific billing codes or authorization procedures are unclear.