When does this change take effect?

This change is effective May 14, 2025.

CommercialCoverageMedium impact

11.03.05e, Frenectomy, Frenotomy, or Frenoplasty for Ankyloglossia (Tongue-Tie)

Q: Who is affected by this change?

This affects Independence Blue Cross ENT (Ear, Nose & Throat), Oral & Maxillofacial Surgery, Pediatrics, Dentistry providers on Commercial plans.

Independence Blue Cross·ENT (Ear, Nose & Throat), Oral & Maxillofacial Surgery, Pediatrics +1 more·Medical Policy

Effective date

May 14, 2025

We identified it

Jun 19, 2026

Days to comply

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Summary

This is a reissued policy for frenectomy, frenotomy, or frenoplasty procedures for ankyloglossia (tongue-tie) treatment. The policy has been updated for commercial plans with an effective date of May 14, 2025.

Action Required

Action needed

By May 14, 2025: Billing team must review the updated frenectomy/frenotomy/frenoplasty policy at the source URL to understand any changes to coverage criteria, prior authorization requirements, or billing guidelines for ankyloglossia procedures. Update internal billing protocols and staff training accordingly.

Related policy hubs

Independence Blue Cross policies ENT (Ear, Nose & Throat)Oral & Maxillofacial Surgery Pediatrics Dentistry