Premera Blue Cross of Washington prior authorization 37277
Premera Blue Cross of Washington prior authorization for 37277: Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, 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 the stent placement, atherectomy and angioplasty, when performed, within the same artery, unilateral; complex lesion, initial vessel These criteria do not imply or guarantee approval.
- Code
- 37277
- Description
- Revascularization, endovascular, open or percutaneous, femoral and popliteal vascular territory, with transluminal stent placement, with transluminal atherectomy, 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 the stent placement, atherectomy and angioplasty, when performed, within the same artery, unilateral; complex lesion, initial vessel These criteria do not imply or guarantee approval.
- Source
- Clinical Review by Code List PBCWA, Pg 320 Original policy