SURG.00121 Transcatheter Heart Valve Procedures

This policy addresses transcatheter heart valve procedures, primarily transcatheter aortic valve replacement (TAVR) and transcatheter mitral therapies/devices. TAVR is medically necessary when performed with an FDA‑approved device for severe degenerative native aortic stenosis defined by any one of: AVA ≤1.0 cm², AVA index ≤0.6 cm²/m², mean gradient ≥40 mm Hg, or peak aortic‑jet velocity ≥4.0 m/s. Procedures that do not meet these criteria are not medically necessary, and the following are investigational/not medically necessary for all indications: TAVR cerebral protection devices, transcatheter mitral edge‑to‑edge/mitral valve repair for other indications, valve‑in‑valve transcatheter mitral valve replacement, percutaneous mitral annuloplasty, and transcatheter mitral valve replacement.

"TAVR using a U."

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