CommercialCoverageMedium impact
ChangeHealth Interqual April 2022 Release – Informational Update
Blue Cross Blue Shield of Rhode Island·RI · Cardiology, Cardiothoracic Surgery·Physician / Facility
Effective date
May 1, 2022
We identified it
Jun 19, 2026
Summary
ChangeHealth Interqual updated criteria for Transcatheter Aortic Valve Replacement (TAVR) in April 2022, clarifying that aortic velocity and pressure gradient measurements must be taken at rest and expanding eligibility to include asymptomatic severe aortic stenosis patients. The policy also confirms life expectancy must exceed 1 year regardless of surgical risk level.
Action Required
Immediately: Billing and clinical teams must ensure TAVR prior authorization requests specify that aortic velocity and pressure gradient measurements were taken at rest. Update clinical documentation templates to capture resting hemodynamic values and confirm life expectancy >1 year is documented for all TAVR cases, including asymptomatic patients.