86335 Insurance Policy Changes

Venous Stenting for the Treatment of Idiopathic Intracranial Hypertension (CPB 1039, reviewed 2026-01-14)

Aetna has updated its medical policy (CPB 1039) to establish coverage criteria for venous stenting in the transverse sinus for treatment of medically refractory idiopathic intracranial hypertension (IIH). The policy specifies 10 strict medical necessity criteria that must be met for coverage of CPT 61635, and explicitly excludes intravascular ultrasound (CPT 37252, 37253) as experimental. Billing teams must implement prior authorization requirements and ensure all documentation criteria are present before claim submission.