Medicare AdvantageCoverageMedium impact
MA11.069f, Reduction Mammoplasty
Independence Blue Cross·Plastic Surgery, General Surgery·Claims & Billing
Effective date
Apr 30, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA11.069f for Reduction Mammoplasty has been reissued and will take effect April 30, 2025. This is a policy update that may affect coverage criteria, prior authorization requirements, or billing procedures for breast reduction surgeries under Medicare Advantage plans.
Action Required
Before April 30, 2025: Billing team and providers must review the updated MA11.069f Reduction Mammoplasty policy at the IBX website to identify any changes to coverage criteria, prior authorization requirements, or documentation standards. Update billing procedures and encounter forms accordingly to ensure compliance with the new policy requirements.