Transcatheter Aortic-Valve Implantation for Aortic Stenosis
Defines medical necessity criteria, documentation and coding guidance, investigational indications (including cerebral embolic protection devices), and related definitions for transcatheter aortic valve replacement (including valve-in-valve) in individuals with native or bioprosthetic aortic valve disease.
Policy replaced prior policy 7.01.585; header shows Replaces: Aug. 1, 2025 and Last Revised Apr. 1, 2026.
For TAVI and ViV TAVI, the criterion of left ventricular ejection fraction greater than 20% was removed.
Statement added for consideration of individuals at increased surgical risk not demonstrated on STS score; requires documentation by at least 2 cardiovascular specialists including a cardiac surgeon.
Use of a cerebral embolic protection device during TAVR is considered investigational.
HCPCS code C8010 added effective April 1, 2026.