Transcatheter pulmonary valve replacement
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Defines medical necessity and coverage criteria for transcatheter pulmonary valve replacement (including Melody, Harmony, Edwards SAPIEN 3 with Alterra) for members with pulmonary valve stenosis or insufficiency and related right ventricular outflow tract dysfunction.
Policy transitioned from Melody-only to a device-agnostic TPVR policy covering Melody, Harmony, and Edwards SAPIEN 3 with the Alterra Adaptive Prestent and extended eligibility to native or surgically repaired RVOTs.
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