National Coverage Determination 20.7: Percutaneous Transluminal Angioplasty

Related CR Release Date: April 11, 2024
Effective Date: October 11, 2023
Implementation Date: May 13, 2024
MLN Matters Number: MM13512
Related Change Request (CR) Number: CR 13512
Related CR Transmittal Numbers: R12571CP; R12571NCD

CR 13512 tells you about changes in coverage for PTA of the carotid artery concurrent with stenting effective October 11, 2023:

  • Patients don’t have to enroll in a clinical trial
  • Facilities don’t need CMS approval to perform this service
  • You must engage in formal shared decision-making with the patient
  • MACs can decide if this service is covered if it’s not addressed in this NCD

Your MAC will adjust claims processed in error that you bring to their attention.

Make sure your billing staff knows about these changes.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)13512.

Last Updated Apr 25 , 2024