NCDActive
Hemorheograph
NCD180
Effective: January 1, 1966
Updated: December 31, 2025
Policy Summary
Coverage for hemorheograph testing is limited to preoperative and postoperative diagnostic evaluation of suspected peripheral artery disease and for assessing skin perfusion prior to minor extremity (including podiatric) procedures. The device is not a plethysmograph, does not measure total digit or limb blood flow, and is not covered for indications outside evaluation of peripheral vascular disease. Documentation must support suspected peripheral artery disease or the planned minor procedure and must include recorded test results.
Coverage Criteria Preview
Key requirements from the full policy
"Coverage is provided for hemorheograph testing when performed as a preoperative diagnostic evaluation for patients with suspected peripheral artery disease."
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