DraftBlue Cross Blue Shield - Rhode IslandPolicy N/A

Removal of Implantable Devices

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This policy governs coverage and authorization handling for removal of surgically implanted devices for Medicare Advantage and Commercial products in Rhode Island.

Policy Summary

PayerBlue Cross Blue Shield - Rhode Island

PolicyRemoval of Implantable Devices

Policy CodePolicy N/A

Change TypeCoverage and authorization revision

Effective DateJanuary 1, 2027

Last ReviewOct 21, 2026

Next Review DateN/A

Key ActionVerify applicable surgery benefits and coverage in the member's Benefit Booklet, Evidence of Coverage, or Subscriber Agreement.

SourceLink

POLICY UPDATE CHANGES

Prior authorization requirements revised by product line.

Removal of a surgically implanted device is considered medically necessary effective January 1, 2027.

01/01/2027Effective date

2Product lines

Not requiredMedicare Advantage authorization

Not recommendedCommercial authorization

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DraftBlue Cross Blue Shield - Rhode IslandPolicy N/A

Removal of Implantable Devices

Customize your policy alerts

Sign up for all Blue Cross Blue Shield - Rhode Island policy alerts

Know when Blue Cross Blue Shield - Rhode Island releases new policies or updates existing guidance.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

This policy governs coverage and authorization handling for removal of surgically implanted devices for Medicare Advantage and Commercial products in Rhode Island.

Policy Summary

PayerBlue Cross Blue Shield - Rhode Island

PolicyRemoval of Implantable Devices

Policy CodePolicy N/A

Change TypeCoverage and authorization revision

Effective DateJanuary 1, 2027

Last ReviewOct 21, 2026

Next Review DateN/A

Key ActionVerify applicable surgery benefits and coverage in the member's Benefit Booklet, Evidence of Coverage, or Subscriber Agreement.

SourceLink

POLICY UPDATE CHANGES

Prior authorization requirements revised by product line.

Removal of a surgically implanted device is considered medically necessary effective January 1, 2027.

01/01/2027Effective date

2Product lines

Not requiredMedicare Advantage authorization

Not recommendedCommercial authorization

Medical Necessity

Removal of surgically implanted devices

Effective January 1, 2027, removal of a surgically implanted device is considered medically necessary.

Removal of surgically implanted device: Removal of a surgically implanted device is considered medically necessary.

No additional clinical criteria are specified in the policy.

Verify Member-Specific Benefits

Note

Verify member-specific benefits

Verify the member’s applicable surgery benefits and coverage before proceeding, because coverage and payment may vary between groups and contracts.

Refer to the appropriate Benefit Booklet, Evidence of Coverage, or Subscriber Agreement.

Policy Summary

PayerBlue Cross Blue Shield - Rhode Island

PolicyRemoval of Implantable Devices

Policy CodePolicy N/A

Change TypeCoverage and authorization revision

Effective DateJanuary 1, 2027

Last ReviewOct 21, 2026

Next Review DateN/A

Key ActionVerify applicable surgery benefits and coverage in the member's Benefit Booklet, Evidence of Coverage, or Subscriber Agreement.

SourceLink

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