Medicare AdvantageCoverageMedium impact
MA11.077h, Prophylactic Mastectomy, Oophorectomy/Salpingo-Oophorectomy, and Hysterectomy
Independence Blue Cross·OB-GYN, General Surgery, Oncology·Medical Policy
Effective date
Apr 30, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA11.077h regarding prophylactic mastectomy, oophorectomy/salpingo-oophorectomy, and hysterectomy has been reissued with an effective date of April 30, 2025. This is a policy reissue rather than a new policy change, indicating potential updates to existing coverage criteria or administrative requirements for these preventive surgical procedures.
Action Required
Before April 30, 2025: Billing and clinical teams should review the updated MA11.077h policy details for any changes to coverage criteria, prior authorization requirements, or documentation standards for prophylactic mastectomy, oophorectomy, salpingo-oophorectomy, and hysterectomy procedures. Access the full policy document from the source URL to identify specific billing or clinical workflow changes that may be required.