Angioplasty and Stenting of Extra-Cranial and Intra-Cranial Arteries

Covered: PTA (± stent/embolic protection) of extracranial carotid arteries for symptomatic ≥50% stenosis, PTA (± stent/embolic protection) of extracranial vertebral arteries for symptomatic ≥50% stenosis refractory to optimal medical therapy, intracranial angioplasty for medically refractory symptomatic delayed cerebral ischemia after aneurysmal SAH, endovascular stent‑assisted coiling or flow‑diverter repair of intracranial aneurysms, and EC‑IC bypass for specified indications; excluded/experimental: intracranial angioplasty/stenting for atherosclerotic intracranial stenosis, prophylactic/treatment uses after SAH (except as above), drug‑eluting stents for extracranial arteries, TCAR, intracranial angioplasty/stenting for emergent large‑vessel occlusion, and other unestablished indications. Key requirements: interventions generally require symptomatic disease with ≥50% stenosis (vertebral only after failure of optimal medical therapy), intracranial vasospasm treatment must be medically refractory delayed cerebral ischemia after SAH, and certain CPT/ICD‑10 codes are restricted (e.g., prophylactic intracranial angioplasty after SAH not covered unless dual diagnosis of SAH and ischemia) with appropriate documentation of prior medical therapy and imaging.