Premera Blue Cross of Washington prior authorization 37270
Premera Blue Cross of Washington prior authorization for 37270: Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform stent placement and angioplasty, when performed, within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to primary code) These criteria do not imply or guarantee approval.
- Code
- 37270
- Description
- Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, including transluminal angioplasty when performed, including all maneuvers necessary for accessing and selectively catheterizing the artery and crossing the lesion, including all imaging guidance and radiological supervision and interpretation necessary to perform stent placement and angioplasty, when performed, within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to primary code) These criteria do not imply or guarantee approval.
- Source
- Clinical Review by Code List PBCWA, Pg 316 Original policy