August 2023 medical policy updates

Our Medical Advisory Committee (MAC), comprised of network physicians contracted with Priority Health, met this month and approved a series of medical policy updates. All updates are outlined in our policy updates webpage; below is a new policy we want to draw your attention to:

Supporting lower extremity atherosclerosis management

With our new medical policy, Intravascular Lithotripsy (#91639), we’re striving to maximize our providers’ ability to manage atherosclerosis of the lower extremities endovascularly. The policy will go into effect on October 23 and outlines the following coverage positions:

Services	Coverage
C9764-C9767 Limb perfusion in the proximal lower extremities	Covered for all lines of business
C9772-C9775 Interventions in the distal aspect of the lower extremity	Not separately payable for Commercial and Medicaid, not medically necessary Covered for Medicare
C1761 Catheter, transluminal intravascular lithotripsy, coronary	Not separately payable for Commercial and Medicaid Covered for Medicare