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Occlusion of Uterine Arteries Using Transcatheter Embolization
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
Transcatheter embolization of uterine arteries is considered medically necessary as a treatment of uterine fibroids or as a treatment of postpartum uterine hemorrhage. One repeat transcatheter embolization of uterine arteries to treat persistent fibroid symptoms after an initial uterine artery embolization may be considered medically necessary. Transcatheter embolization for cervical ectopic pregnancy, uterine arteriovenous malformation and adenomyosis is considered investigational.
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What to do
Action · 7 steps
01REQUIREMENTS: Billing team: Treat transcatheter uterine artery embolization for uterine fibroids or postpartum uterine hemorrhage as medically necessary, and treat embolization for cervical ectopic pregnancy, uterine arteriovenous malformation and adenomyosis as investigational.
02Billing team: A repeat uterine artery embolization may be performed when there is documentation of continued symptoms such as bleeding or pain.
03Repeat procedures may be most appropriate when persistent symptoms occur together with imaging findings of an incomplete initial procedure, as evidenced by continued blood flow to the treated regions.
04Billing team: The policy sets no specific criteria for uterine artery embolization regarding the size, location or multiplicity of fibroids; the general criteria it cites are asymptomatic fibroids palpable abdominally that are a concern to the patient, excessive uterine bleeding, and pelvic discomfort.
05Billing team: CPT 36299 and 37243 are medically necessary only when the procedure is performed according to the policy section.
06Billing team: BCBSMS makes no payment for services not documented to be medically necessary, and a provider's prescription or approval does not in itself make a service medically necessary.
07Billing team: Check the member's specific benefit plan language, because the coverage guidelines in the Medical Policy Manual should not be used in lieu of it.
Codes mentioned
3629937243D25.0D25.1D25.2D25.9O72.0O72.1O72.2
Original notice
Occlusion of Uterine Arteries Using Transcatheter Embolization
bcbsms.com · Always check the source before changing claims.
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