Effective October 1, 2023, Ambetter, Meridian Medicaid Plan, Meridian Medicare-Medicaid Plan (MMP), YouthCare, and Wellcare of Illinois (Wellcare) are reinforcing the prior auth review for leg stent coding
Summary of Policy
We are reminding providers the following vascular codes require a medical necessity review, therefore please submit complete supporting clinical records, including clinical notes, for prior authorization requests for the codes noted below.
|
CPT Description |
CTP Code |
|
ILIAC REVASC |
37220 |
|
ILIAC REVASC W/STENT |
37221 |
|
FEM/POPL REVAS W/TLA |
37224 |
|
FEM/POPL REVAS W/ATHER |
37225 |
|
FEM/POPL REVASC W/STENT |
37226 |
|
FEM/POPL REVASC STNT & ATHER |
37227 |
|
TIB/PER REVASC W/TLA |
37228 |
|
TIB/PER REVASC W/ATHER |
37229 |
|
TIB/PER REVASC W/STENT |
37230 |
|
TIB/PER REVASC STENT & ATHER |
37231 |
Please review the Endovascular Intervention Peripheral Artery.
We are here to help. Please contact your Provider Relations representative for general inquiries.
For Meridian Provider Services call 866-606-3700, Monday through Friday, from 8 a.m. to 5 p.m.
For Meridian MMP Provider Services call 855-580-1689, Monday through Friday, from 8 a.m. to 5 p.m.
For Wellcare Provider Services call 855-538-0454, Monday through Sunday, from 8 a.m. to 8 p.m.
For YouthCare Provider Services call 844-289-2264, Monday through Friday, from 8 a.m. to 6 p.m.
