AetnaAll Plans · Coverage · Medical Policy · CardiologyMedium impact
Coronary Artery Brachytherapy and Other Adjuncts to Coronary Interventions (CPB 0491, reviewed 2026-07-30)
Effective date
Not stated in the notice
Identified
Aug 15, 2026
Summary
Aetna considers coronary artery brachytherapy medically necessary as adjunctive treatment during a second angioplasty or stent placement when blockage has re-occurred within the localized area of a previously placed stent (in-stent re-stenosis), in native coronary arteries or coronary artery bypass grafts. Aetna also considers intravascular shockwave lithotripsy (IVL) medically necessary for hemodynamically significant, heavily calcified coronary stenoses (for example, calcium extending over 270 degrees) where primary stenting is not possible. Coronary artery brachytherapy is considered experimental, investigational, or unproven for primary prevention of re-stenosis and all other indications outside those listed.
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01Billing team: Bill CPT 92974 and HCPCS C7533 and Q3001 for coronary brachytherapy only when it is used as adjunctive treatment during a second angioplasty or stent placement for in-stent re-stenosis, where blockage has re-occurred within the localized area of a previously placed stent, in native coronary arteries or coronary artery bypass grafts.
02Bill CPT 92972 (percutaneous transluminal coronary lithotripsy) only for hemodynamically significant, heavily calcified coronary stenoses, such as calcium extending over 270 degrees, where primary stenting is not possible.
03Brachytherapy for primary prevention of re-stenosis and all other indications not listed in the policy is considered experimental, investigational, or unproven.
04HCPCS C1761 and C7571 are not covered for the indications listed in the policy.
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