Who is affected by this change?

This affects Independence Blue Cross Gastroenterology providers on Medicare Advantage plans.

When does this change take effect?

This change is effective Sep 18, 2024.

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Medicare AdvantageCoverageLow impact

MA11.117, Peroral Endoscopic Myotomy (POEM) Procedures

Independence Blue Cross·Gastroenterology·Medical Policy

Effective date

Sep 18, 2024

We identified it

Jun 19, 2026

Days to comply

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Summary

Policy MA11.117 regarding Peroral Endoscopic Myotomy (POEM) procedures has been reissued for Medicare Advantage plans. This policy covers a specialized endoscopic procedure used to treat esophageal motility disorders like achalasia.

Action Required

Action needed

Review updated MA11.117 policy for POEM procedures to understand current coverage criteria and documentation requirements for Medicare Advantage patients. Ensure billing staff are aware of any changes to prior authorization or medical necessity requirements for these specialized gastroenterology procedures.

Related policy hubs

Independence Blue Cross policies Gastroenterology