NCDActive
Extracranial-Intracranial (EC-IC) Arterial Bypass Surgery
NCD54
Effective: March 27, 1991
Updated: December 31, 2025
Policy Summary
Extracranial-intracranial (EC-IC) arterial bypass surgery is not covered for treatment or prevention of stroke due to ischemic cerebrovascular disease of the carotid or middle cerebral arteries. The procedure is considered not reasonable and necessary under §1862(a)(1) of the Act for these indications.
Coverage Criteria Preview
Key requirements from the full policy
"EC-IC arterial bypass surgery is not covered when performed as a treatment for ischemic cerebrovascular disease of the carotid or middle cerebral arteries, including treatment or prevention of stro..."
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