Medical Policy Policy Title Endovascular Therapies for Extracranial Vertebral Artery Disease

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Endovascular therapy, including percutaneous transluminal angioplasty with or without stenting, is considered investigational for the management of extracranial vertebral artery disease. There is insufficient evidence to support a conclusion concerning the health outcomes or benefits associated with this procedure. Policy Guidelines The extracranial vertebral artery is considered to be segments V1-V3 of the vertebral artery from its origin at the subclavian artery until it crosses the dura mater.

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7.01.148 Endovascular Therapies for Extracranial Vertebral Artery Disease

If stenting is indicated, CPT instructs that when the ipsilateral extracranial vertebral arteriogram (including imaging and selective catheterization) confirms the need for stenting, then 0075T and 0076T include all ipsilateral extracranial vertebral catheterization, all diagnostic imaging for ipsilateral extracranial vertebral artery stenting, and all related radiologic supervision and interpr...

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If stenting is indicated, CPT instructs that when the ipsilateral extracranial vertebral arteriogram (including imaging and selective catheterization) confirms the need for stenting, then 0075T and 0076T include all ipsilateral extracranial vertebral catheterization, all diagnostic imaging for ipsilateral extracranial vertebral artery stenting, and all related radiologic supervision and interpr...

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Endovascular Therapies for Extracranial Vertebral Artery Disease

©2017 Blue Cross and Blue Shield of Louisiana An independent licensee of the Blue Cross and Blue Shield Association No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, or otherwise, without permission from Blue Cross and Blue Shield of Louisiana. Page 1 of 12 Applies to all products admin...

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تاریخ انتشار 2017