Premera Blue Cross of Washington prior authorization 37292
Premera Blue Cross of Washington prior authorization for 37292: Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty, 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 within the same artery, unilateral; straightforward lesion, initial vessel
- Code
- 37292
- Description
- Revascularization, endovascular, open or percutaneous, tibial and peroneal vascular territory, with transluminal stent placement, with transluminal atherectomy, including transluminal angioplasty, 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 within the same artery, unilateral; straightforward lesion, initial vessel
- Source
- Clinical Review by Code List PBCWA, Pg 328 Original policy