Intravascular Ultrasound

Aetna considers intravascular ultrasound (IVUS) medically necessary only to help decide on intracoronary intervention for symptomatic patients with 50–70% angiographic stenosis, to assess suspected left main disease not seen on angiography, to guide vena caval filter placement, to guide placement and immediate assessment of intracoronary endoluminal devices (including angioplasty/atherectomy/stenting and grafts), and to evaluate cardiac allograft vasculopathy. IVUS is excluded/experimental for screening or diagnosing vulnerable plaques and for numerous non‑coronary uses (e.g., pulmonary hypertension, peripheral/venous/carotid procedures, aortic dissection, lower‑extremity arterial disease), and its use is limited to the specified medically necessary scenarios.

"As a guidance for placement of vena caval filter;"

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