What insurance policy changes affect CPT 36245?

There are 10 tracked policy changes affecting CPT 36245, including updates from Humana, Blue Cross Blue Shield of North Dakota, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 36245?

Payers that have issued tracked updates for CPT 36245 include: Humana, Blue Cross Blue Shield of North Dakota, Aetna, Independence Blue Cross.

How do I get notified when CPT 36245 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 36245. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 36245?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

36245 — A doctor inserts a thin tube into an artery in your abdomen or lower body for a medical procedure.: Insurance Policy Changes

36245 Insurance Policy Changes

CPT 36245, in plain terms, covers A doctor inserts a thin tube into an artery in your abdomen or lower body for a medical procedure. CPT 36245 is referenced in 10 tracked payer policy changes from Humana, Blue Cross Blue Shield of North Dakota, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 36245 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Medium impact

Pelvic Congestion Syndrome Treatments (CPB 0441, reviewed 2026-07-09)

Aetna·Effective Jul 9, 2026

Aetna's updated Clinical Policy Bulletin 0441 (effective 2026-07-09) establishes coverage criteria for pelvic congestion syndrome treatments, covering gonadal/ovarian vein embolization ONLY when patients have definitive diagnostic imaging (CT/MRI/venography) AND have failed appropriate pharmacotherapy. Median sacral vein embolization, sacral nerve neuromodulation, ovarian vein transposition, and micronized purified flavonoid fraction remain non-covered as experimental/investigational. Billing teams must verify both criteria are met before authorizing claims.

36245 Insurance Policy Changes

Peripheral Artery Revascularization of the Lower Extremities - Medicare Advantage (Revised)

Medical Policy Updates

Liver and Other Neoplasms - Treatment Approaches (CPB 0268, reviewed 2026-04-16)

Pelvic Congestion Syndrome Treatments (CPB 0441, reviewed 2026-07-09)

Peripheral Artery Revascularization of the Lower Extremities - Medicare Advantage (Revised)

Liver and Other Neoplasms - Treatment Approaches (CPB 0268, reviewed 2026-09-18)

11.06.04k, Uterine Artery Embolization

MA11.079e, Evaluation and Treatment of Erectile Dysfunction (ED)

11.06.04k, Uterine Artery Embolization

11.11.01k, Evaluation and Treatment of Erectile Dysfunction (ED)