Lower Extremity Endovascular Procedures – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare covers endovascular revascularization (stents, angioplasty, atherectomy) for non‑limb‑threatening claudication of aortoiliac/femoropopliteal disease and for chronic limb‑threatening ischemia (CLTI) when applicable diagnoses are met, but only if the patient has impaired ADLs/ability to work, has failed ≥12 weeks of supervised or structured exercise plus appropriate pharmacologic therapy and smoking cessation efforts, has objective ischemia (ABI ≤ 0.90), and imaging demonstrating ≥50% stenosis. Procedures are considered unproven/not medically necessary for asymptomatic individuals, non‑limb‑threatening infrapopliteal disease, prevention of claudication progression to CLTI, iliac/transluminal iliac atherectomy, treatment of a nonviable limb, and endovenous femoropopliteal bypass with stent grafts, and documentation (exercise/medication records, ABI, vascular imaging) is required to establish medical necessity.

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