This version of the policy will become effective 01/02/2018.
The following new policy has been developed to communicate the Company’s delegation of precertification/preapproval of percutaneous coronary intervention, coronary angiography, and arterial ultrasound to AIM Specialty Health® (AIM), with the exception of services performed on an emergent basis.
When services can be administered in various settings, the Company reserves the right to reimburse only those services that are furnished in the most appropriate and cost-effective setting that is appropriate to the member’s medical needs and condition. This decision is based on the member’s current medical condition and any required monitoring or additional services that may coincide with the delivery of this service.
This Medical Policy Bulletin document describes the status of medical technology at the time the document was developed. Since that time, new technology may have emerged or new medical literature may have been published. This Medical Policy Bulletin will be reviewed regularly and be updated as scientific and medical literature becomes available. For more information on how Medical Policy Bulletins are developed, go to the About This Site section of this Medical Policy Web site.
Policy: 11.02.06l:Catheter Ablation of Cardiac Arrhythmias
Policy: 11.02.10m:Endovascular Grafts for Abdominal Aortic Aneurysms (AAA), Aortic-Iliac Aneurysms, and Infrarenal Aortic Aneurysms
Policy: 11.02.11g:Transcatheter Closure of Cardiac Septal Defects
Policy: 11.02.12i:Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting of the Extracranial Carotid Artery or Intracranial Artery
Policy: 11.02.16r:Ventricular Assist Devices (VADs)
Policy: 11.02.17f:Endovascular Stent-Graft Repair of Thoracic Aortic Aneurysms and Nonaneurysmal Lesions
Policy: 11.02.25f:Transcatheter Cardiac Valve Procedures
Policy: 11.02.26a:Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial Fibrillation