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Blue Shield of CaliforniaAll Plans · Coverage · Medical Policy · CA · Cardiology, Internal MedicineHigh impact

Renal Denervation for Uncontrolled Hypertension (7.01.136)

Effective date
Mar 1, 2026
Identified
Mar 1, 2026

Summary

Blue Shield of California's medical policy 7.01.136 now considers radiofrequency ablation of the renal sympathetic nerves medically necessary for individuals whose blood pressure remains above 130/80 mmHg despite use of 3 or more antihypertensive medications from 3 classes at maximally tolerated doses, or with intolerance to antihypertensive medications whose blood pressure remains uncontrolled despite attempting lifestyle modifications. The policy also considers ultrasound ablation of the renal sympathetic nerves medically necessary under the same criteria. Before this version, radiofrequency ablation was considered investigational for the treatment of uncontrolled hypertension, and the effective date of this version is March 1, 2026.

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What to do

Action · 8 steps
01Already effective March 1, 2026: For radiofrequency or ultrasound renal denervation, confirm the member meets the policy criteria: blood pressure above 130/80 mmHg despite 3 or more antihypertensive medications from 3 classes at maximally tolerated doses, or intolerance to antihypertensive medications with blood pressure still uncontrolled despite attempting lifestyle modifications.
02Confirm none of the listed contraindications apply: pregnancy, fibromuscular dysplasia, stented renal artery, renal artery aneurysm, significant renal artery stenosis, known kidney or secreting adrenal tumors, and unaddressed causes of secondary hypertension.
03Confirm the procedure is planned for an experienced, specialized center with a multidisciplinary hypertension team, after shared decision-making about the risks and benefits with the individual.
04Note that there is too little data to support use for stage 1 hypertension, isolated systolic hypertension, stage 4 or 5 chronic kidney disease, a single kidney, kidney transplant recipients, or redo renal denervation in individuals who fail to respond to initial renal denervation.
05Check the member's contract benefits in effect at the time of service, because the health services contract language controls coverage.
06The policy lists no records required for clinical review.
07Direct questions about this policy's applicability to the Prior Authorization Department at (800) 541-6652.
08Check the current policy at the source link to confirm these criteria still apply to the dates of service.

Codes mentioned

C1735C1736

Original notice

Renal Denervation for Uncontrolled Hypertension (7.01.136)
blueshieldca.com · Always check the source before changing claims.
View original ↗

Related policy hubs

Blue Shield of California policiesCA policy changesCardiologyInternal MedicineCode C1735Code C1736

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