Transcatheter Carotid Stent

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Question:

I know Medicare has criteria for when a transcatheter carotid stent is medically covered (paid). We are having a debate regarding whether the criteria related to the percent of arterial occlusion is 70% or 80%. Can you help?

Answer:

In regards to extent of vessel occlusion, Medicare’s current criteria require a 70% occlusion, evidenced by a catheter-based angiogram at the time of the stenting. For the complete Medicare coverage criteria, click here.