Medicare AdvantageCoverageMedium impact
MA11.004m, Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)
Independence Blue Cross·Urology·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA11.004m regarding minimally invasive treatments for urinary outlet obstruction due to benign prostatic hyperplasia (BPH) has been updated. This policy affects coverage and billing for BPH procedures under Medicare Advantage plans.
Action Required
Immediately: Billing team must review the complete MA11.004m policy at the source URL to understand specific coverage changes for BPH minimally invasive treatments under Medicare Advantage plans. Update prior authorization requirements and coverage determinations as specified in the full policy. Ensure all BPH procedure claims comply with new guidelines effective January 1, 2025.