CommercialAdministrativeLow impact
11.02.10p, Endovascular Grafts for Abdominal Aortic Aneurysms (AAA), Aorto-Iliac Aneurysms, and Infrarenal Aortic Aneurysms
Independence Blue Cross·PA · Vascular Surgery, Cardiothoracic Surgery, General Surgery·Medical Policy
We identified it
Jun 19, 2026
Summary
This is a routine annual policy reissuance with no substantive changes to coverage criteria for endovascular graft repair of abdominal aortic aneurysms (AAA), aorto-iliac aneurysms, and infrarenal aortic aneurysms. The policy maintains existing coverage for FDA-approved devices under specified medical necessity criteria and continues to classify all other uses as experimental/investigational and not covered.
Action Required
No immediate action required. This is a policy reissuance with no changes. Billing team should verify that current billing system rules and prior authorization protocols continue to align with the existing coverage criteria: (1) FDA-approved devices must be used, (2) for emergency repair, patient must be stable for CT imaging and aneurysm must be anatomically appropriate. Continue to require medical necessity documentation in patient records. No workflow changes needed unless your practice has not yet implemented the two CPT codes (33894, 33895) added in the January 1, 2022 update.