Lower Extremity Vascular Angiography Nc Cs
UnitedHealthcare medical policy (North Carolina only) defining medical necessity criteria, exclusions, and applicable procedure/diagnosis codes for endovascular revascularization procedures (stents, angioplasty, atherectomy) for lower extremity peripheral artery disease including claudication and chronic limb‑threatening ischemia (CLTI).
Revised medically necessary coverage criteria for endovascular revascularization procedures for non-limb-threatening lower extremity ischemia (claudication), replacing imaging criterion wording with imaging of the target vessel showing moderate-severe stenosis (50% or greater).
Added language that retreatment for in-stent restenosis is proven and medically necessary when recurrent symptoms, impaired ADLs/work, and imaging showing ≥50% stenosis are present.
Added documentation language clarifying that benefit coverage is determined by federal/state/contractual requirements and that medical records may be required for review.
Updated Clinical Evidence and References sections to reflect current information; archived previous policy version CSNCT0602.03.
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