Our Medical Advisory Committee (MAC), comprised of network physicians contracted with Priority Health, met this month and approved a series of medical policy updates. All updates are outlined in our policy updates webpage; below is a new policy we want to draw your attention to:
Supporting lower extremity atherosclerosis management
With our new medical policy, Intravascular Lithotripsy (#91639), we’re striving to maximize our providers’ ability to manage atherosclerosis of the lower extremities endovascularly. The policy will go into effect on October 23 and outlines the following coverage positions:
ServicesCoverage
C9764-C9767
Limb perfusion in the proximal lower extremities
Covered for all lines of business
C9772-C9775
Interventions in the distal aspect of the lower extremity
Not separately payable for Commercial and Medicaid, not medically necessary
Covered for Medicare
C1761
Catheter, transluminal intravascular lithotripsy, coronary
Not separately payable for Commercial and Medicaid
Covered for Medicare