37261 prior authorization | Anthem Blue Cross Blue Shield of California
37261, Revascularization, endovascular, open or percutaneous, iliac 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 the stent placement and angioplasty when performed, within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to code for primary procedure), is on the Anthem Blue Cross Blue Shield of California PPO prior authorization list. Not a coverage or referral decision.
- Code
- 37261
- Description
- Revascularization, endovascular, open or percutaneous, iliac 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 the stent placement and angioplasty when performed, within the same artery, unilateral; complex lesion, each additional vessel (List separately in addition to code for primary procedure)
- Source
- California PPO Prior Authorization List, Pg 97 Original policy
Anthem Blue Cross Blue Shield of California prior authorization