Aortography and peripheral angiography

Invasive diagnostic aortography and peripheral angiography are covered when they are necessary to diagnose or guide treatment for specific vascular conditions (renal artery stenosis, renal aneurysm/trauma, peripheral arterial disease, aortic aneurysm/occlusive disease, ischemic cerebral disease, etc.) and when noninvasive testing is inconclusive or unavailable. Renal angiography generally requires a prior inconclusive or unavailable noninvasive renal artery study (except select cases like fibromuscular dysplasia), routine non-selective 'drive-by' renal arteriography is denied without documented indications, and angiography is allowed only in specified places of service with documentation supporting medical necessity for repeats.

"Selective renal angiography is medically necessary for renovascular occlusive disease including renal artery stenosis, severe or difficult-to-control renal hypertension, resistant hypertension, or ..."