ModifiedBlue Cross Blue Shield - North CarolinaPolicy N/A

Renal Denervation as a Treatment of Hypertension

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BCBSNC policy on coverage and evidence for radiofrequency and ultrasound renal denervation to treat uncontrolled or resistant hypertension for affected members and providers.

Policy Summary

PayerBlue Cross Blue Shield - North Carolina

PolicyRenal Denervation as a Treatment of Hypertension

Policy CodePolicy N/A

Change TypeMaterial revision — investigational stance clarified and title updated

Effective DateJul 16, 2025

Last ReviewMar 11, 2026

Next Review DateFeb 2, 2026

Key ActionVerify member benefits and submit medical records with any prior authorization request; inclusion of procedure codes does not guarantee reimbursement.

SourceLink

POLICY UPDATE CHANGES

Policy statement updated to read: 'Radiofrequency ablation and ultrasound ablation of the renal sympathetic nerves are considered investigational. BCBSNC does not provide coverage for investigational services or procedures.'

Not Covered section updated to read 'Radiofrequency ablation and ultrasound ablation of the renal sympathetic nerves are considered investigational for the treatment of uncontrolled hypertension.'

Billing/Coding section updated with code 0339T re-added and new codes 0935T, C1735, C1736 added effective 1/1/2025.

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ModifiedBlue Cross Blue Shield - North CarolinaPolicy N/A

Renal Denervation as a Treatment of Hypertension

Customize your policy alerts

Sign up for all Blue Cross Blue Shield - North Carolina policy alerts

Know when Blue Cross Blue Shield - North Carolina releases new policies or updates existing guidance.

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BCBSNC policy on coverage and evidence for radiofrequency and ultrasound renal denervation to treat uncontrolled or resistant hypertension for affected members and providers.

Policy Summary

PayerBlue Cross Blue Shield - North Carolina

PolicyRenal Denervation as a Treatment of Hypertension

Policy CodePolicy N/A

Change TypeMaterial revision — investigational stance clarified and title updated

Effective DateJul 16, 2025

Last ReviewMar 11, 2026

Next Review DateFeb 2, 2026

Key ActionVerify member benefits and submit medical records with any prior authorization request; inclusion of procedure codes does not guarantee reimbursement.

SourceLink

POLICY UPDATE CHANGES

Not Covered section updated to read 'Radiofrequency ablation and ultrasound ablation of the renal sympathetic nerves are considered investigational for the treatment of uncontrolled hypertension.'

Billing/Coding section updated with code 0339T re-added and new codes 0935T, C1735, C1736 added effective 1/1/2025.

InvestigationalPolicy stance

2025-07-16Effective

2026-03-11Last review

Nov 2023FDA approvals

5 codesCodes listed

Coverage Criteria

Not covered — investigational

Covered when ALL of the following are met

Policy coverage stance: Radiofrequency ablation and ultrasound ablation of the renal sympathetic nerves are considered investigational for the treatment of uncontrolled hypertension and are not covered by BCBSNC.

Policy states investigational for both modalities. Requests for these services may be denied on that basis.

Radiofrequency ablation and ultrasound ablation of the renal sympathetic nerves are considered investigational for the treatment of uncontrolled hypertension. BCBSNC does not provide coverage for investigational services or procedures.

Effective 7/16/2025: Policy statement updated to read: “Radiofrequency ablation and ultrasound ablation of the renal sympathetic nerves are considered investigational. BCBSNC does not provide coverage for investigational services or procedures.” Notification of this change was issued 5/14/2025.

As stated in the policy, these procedures are investigational; requests for radiofrequency or ultrasound renal denervation may be denied because BCBSNC does not provide coverage for investigational services or procedures.

BCBSNC considers radiofrequency ablation and ultrasound ablation of the renal sympathetic nerves not covered because they are classified as investigational. Providers should verify member benefits before submission and be aware that inclusion of procedure codes in the billing/coding section does not guarantee reimbursement; claims may be denied on the basis of investigational status and medical record review will not change the investigational determination.

Denial Risk

Investigational procedure — denial risk

Radiofrequency ablation and ultrasound ablation of the renal sympathetic nerves are explicitly designated investigational and BCBSNC does not provide coverage for investigational services or procedures; claims or prior authorization requests for these procedures may be denied on that basis.

Policy statement: “Radiofrequency ablation and ultrasound ablation of the renal sympathetic nerves are considered investigational. BCBSNC does not provide coverage for investigational services or procedures.”
Not covered detail: “Radiofrequency ablation and ultrasound ablation of the renal sympathetic nerves are considered investigational for the treatment of uncontrolled hypertension.”

Billing / Coding

Applicable service codesmixed

0338T	Applicable service code listed
0339T	Applicable service code listed
0935T	Applicable service code listed
C1735	Applicable service code listed
C1736	Applicable service code listed

Prior authorization / coding note (codes referenced)mixed

0338T	Applicable service code listed
0339T	Applicable service code listed
0935T	Applicable service code listed
C1735	Applicable service code listed
C1736	Applicable service code listed

Billing/Coding updates (effective dates)mixed

0339T	CPT code re-added to Billing/Coding section (added 12/31/24)
0935T	New code added to Billing/Coding section, effective 1/1/2025
C1735	New code added to Billing/Coding section, effective 1/1/2025
C1736	New code added to Billing/Coding section, effective 1/1/2025

Provider Actions and Prior Authorization

Prior Authorization

Prior authorization / coding note — codes listed do not ensure payment

Inclusion of procedure codes in the Billing/Coding section does not guarantee reimbursement; BCBSNC may require medical records and prior authorization processes per administrative policies.

Applicable service codes listed: 0338T, 0339T, 0935T, C1735, C1736

Note

Coding updates (informational for prior auth)

Billing/Coding section was updated: code 0339T was re-added and codes 0935T, C1735, and C1736 were added effective 1/1/2025; prior authorization processes would reference these codes if submitted, but the policy considers the procedures investigational.

0339T re-added (12/31/24)
0935T, C1735, C1736 added, effective 1/1/2025

Background

Uncontrolled hypertension affects a large portion of U.S. adults and is associated with increased risk of stroke, ischemic heart disease, kidney disease, and peripheral arterial disease. Renal denervation—percutaneous catheter‑based ablation of the renal sympathetic nerves using radiofrequency energy or endovascular ultrasound—aims to reduce sympathetic activity and lower blood pressure.

Clinical trials (including SPYRAL, RADIANCE, and RADIOSOUND among others) have shown mixed results: some randomized studies report short‑term reductions in blood pressure compared with sham, but there remains uncertainty about the durability of effect and which patient subgroups derive sustained benefit.

Given the current evidence and BCBSNC’s assessment, procedures that ablate the renal sympathetic nerves via radiofrequency or ultrasound are considered investigational for treatment of uncontrolled hypertension, and therefore are not covered.

Definitions

Uncontrolled hypertension / resistant hypertension definition

Uncontrolled hypertensionBlood pressure remains above targeted levels when a patient is not using or unable to use treatments, or when hypertension persists despite antihypertensive therapies; includes resistant hypertension (BP above target despite use of 3 or more antihypertensive medications, including a diuretic).

Resistant hypertension (included under uncontrolled)Blood pressure above target despite use of 3 or more antihypertensive medications, including a diuretic, with complementary mechanisms of action.

Contributing factorsNonadherence, excessive salt intake, inadequate medication dosing, excess alcohol, volume overload, drug-induced hypertension, secondary causes (eg, obstructive sleep apnea).

Renal denervation (RFA and usRDN) definition

Renal denervation — generalPercutaneous, catheter-based procedures that disrupt renal sympathetic nerves to reduce afferent and efferent sympathetic signaling between the kidneys and brain, decreasing vasoconstriction and renin-angiotensin activation.

Policy Summary

PayerBlue Cross Blue Shield - North Carolina

PolicyRenal Denervation as a Treatment of Hypertension

Policy CodePolicy N/A

Change TypeMaterial revision — investigational stance clarified and title updated

Effective DateJul 16, 2025

Last ReviewMar 11, 2026

Next Review DateFeb 2, 2026

Key ActionVerify member benefits and submit medical records with any prior authorization request; inclusion of procedure codes does not guarantee reimbursement.

SourceLink

On This Page

Note

Verify member benefits before submission

Member benefit language should be reviewed because benefit design may affect coverage determination for renal denervation procedures.

Step Therapy

Step therapy / sequencing — none specified

No step therapy or sequencing requirements are specified in the policy; terminology was clarified from 'resistant' to 'uncontrolled' hypertension but the investigational stance remains.

Documentation Required

Medical record submission — supply requested documentation

BCBSNC may request medical records for determination of medical necessity; when records are requested include the specific clinical information needed because letters of support alone are not sufficient.

Include clinical records that address medical necessity; letters of support/explanation are not sufficient unless all required information is present

Documentation Required

Documentation implication — investigational status unaffected by records

Because the policy states these procedures are investigational, documentation supporting medical necessity will not change the investigational determination per the policy statement.

Denial Risk

Investigational — coverage denial risk

Requests for radiofrequency or ultrasound renal denervation may be denied because BCBSNC considers these procedures investigational and does not provide coverage for investigational services or procedures.

Radiofrequency ablation (RFA)Performed percutaneously via femoral artery access; a catheter delivers controlled low‑power radiofrequency energy to the renal artery wall to ablate sympathetic nerves.

Ultrasound renal denervation (usRDN)Catheter-based procedure using an intravascular balloon cooled with fluid; ultrasound energy (typically 2–3 emissions per renal artery) is delivered to ablate renal sympathetic nerves; may treat main and accessory renal arteries.

Uncontrolled hypertension term usage in policy (no numeric thresholds defined)

Policy term usageThe policy uses the term 'uncontrolled hypertension' (replacing prior wording 'resistant') in the Not Covered section to describe the condition addressed by renal denervation, without specifying numeric blood pressure thresholds in the policy text.

Terminology changeWording was revised to replace 'resistant' with 'uncontrolled' hypertension in the 5/1/24–5/14/25 updates and the Not Covered section reflects the updated term.

Implication for coverage decisionsAlthough the term 'uncontrolled hypertension' is used, the policy does not define numeric BP targets or thresholds; investigational status is applied to the procedures for treatment of this condition.