This version of the policy will become effective 12/30/2019.
The policy has been reviewed and reissued to communicate the Company’s continuing position on Endovascular Stent-Graft Repair of Thoracic Aortic Aneurysms and Nonaneurysmal Lesions. Clinical information updated to reiterate Experimental/Investigational position for the use of wireless endovascular pressure sensors.
Current published studies are lacking support for the use of wireless pressure sensors to indicate endoleaks in aneurysm repairs. Further long-term studies are needed to assess for any long-term complications. The evidence to date consists mainly of small case series, which is insufficient to permit conclusions concerning the effect of this device on health outcomes.
THE FOLLOWING CODES ARE USED TO REPRESENT AN UNSUCCESSFUL ENDOVASCULAR REPAIR OF AN ABDOMINAL AORTIC ANEURYSM (AAA) THAT REQUIRED TREATMENT WITH AN URGENT OR EMERGENT OPEN PROCEDURE:
34830, 34831, 34832
THE FOLLOWING CODE IS USED TO REPRESENT THE IMPLANTATION OF THE WIRELESS INTRA- ANEURYSM PRESSURE SENSOR ENDOSURE:
I71.3 Abdominal aortic aneurysm, ruptured
I71.4 Abdominal aortic aneurysm, without rupture
I72.3 Aneurysm of iliac artery
Q25.43 Congenital aneurysm of aorta
S35.09xA Other injury of abdominal aorta, initial encounter
S35.09xD Other injury of abdominal aorta, subsequent encounter
S35.09xS Other injury of abdominal aorta, sequela