CommercialCoverageMedium impact
Angioplasty and Stenting of Extracranial, Intracranial and Vertebral Arteries 7.01.110
Excellus BlueCross BlueShield·Neurology, Vascular Surgery, Cardiology +1 more·Nervous Systems (Neurology)
Effective date
Dec 18, 2025
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield updated their policy for carotid artery angioplasty and stenting procedures. The policy establishes specific coverage criteria for extracranial carotid procedures based on stenosis severity and surgical risk, while classifying vertebral and intracranial procedures as investigational (not covered).
Action Required
By December 18, 2025: Billing team must review all carotid angioplasty and stenting claims to ensure proper documentation of stenosis percentage (>50% for symptomatic patients, >70% for asymptomatic patients) and high surgical risk factors before submitting to Excellus BCBS. Update pre-authorization protocols to verify patients meet medical necessity criteria. Flag vertebral and intracranial angioplasty procedures as investigational - these will likely be denied coverage.