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Medicare AdvantageCoverageMedium impact

MA07.017g, Hyperthermic Intraperitoneal Chemotherapy for Select Intra-Abdominal and Pelvic Malignancies

Independence Blue Cross·Oncology, General Surgery·Medical Policy
Effective date
Jun 16, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

Medicare Advantage has updated their policy for Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for select intra-abdominal and pelvic malignancies, affecting coverage positions, medical necessity criteria, and coding requirements. This specialized cancer treatment policy includes changes to general descriptions and guidelines.

Action Required

Action needed
By June 16, 2025: Billing team must review updated MA07.017g policy at https://medpolicy.ibx.com for new coverage criteria, medical necessity requirements, and coding guidelines for HIPEC procedures. Update prior authorization workflows and documentation requirements for Medicare Advantage patients receiving hyperthermic intraperitoneal chemotherapy. Ensure providers are aware of revised medical necessity criteria to prevent claim denials.