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April 2019
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CMS Transmittals

National Coverage Determination
Procedure Code: 8XXXX
Percutaneous Transluminal Angioplasty (PTA)
CMS Policy Number: 20.7
Back to NCD List

Description: Providers of covered intracranial PTA with stenting shall use Category B IDE billing requirements, as listed in section 68.4. In addition to these requirements, providers must bill the appropriate procedure & dx codes to receive payment. Under Part B, providers must bill procedure code 37799 along with a dx code of I67.2 Cerebral atherosclerosis

To review all requirements of this policy, please see: CMS NCD listing by Chapter

Covered ICD-10 Codes.

I63.031 Cerebral infrc due to thrombosis of right carotid artery
I63.032 Cerebral infarction due to thrombosis of left carotid artery
I63.131 Cerebral infarction due to embolism of right carotid artery
I63.132 Cerebral infarction due to embolism of left carotid artery
I63.231 Cereb infrc due to unsp occls or stenos of right carotid art
I63.232 Cereb infrc due to unsp occls or stenos of left carotid art
I63.59 Cereb infrc due to unsp occls or stenosis of cerebral artery
I65.21 Occlusion and stenosis of right carotid artery
I65.22 Occlusion and stenosis of left carotid artery
I65.23 Occlusion and stenosis of bilateral carotid arteries
I65.8 Occlusion and stenosis of other precerebral arteries
I67.2 Cerebral atherosclerosis
Z00.6 Encntr for exam for nrml cmprsn and ctrl in clncl rsrch prog

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All code-pairs and Medicare coverage information are compiled directly from Center for Medicare and Medicaid Services (CMS) and Medicare Contractor coverage policies. CodeMap® has made every reasonable effort to ensure the accuracy of the information contained. However, the ultimate responsibility for correct coding and claims submission lies with the provider of services. Both CMS and Medicare contractor coverage policy information may change at any time. CodeMap® makes no representation, warranty, or guarantee that this compilation of coverage policy information is error-free or that the use of this information will result in Medicare coverage and subsequent payment of claims. Final coverage and payment of claims are subject to many factors exclusively controlled by CMS and its contractors.

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