SCAI Reports on Aetna Atherectomy Policy Update

August 21, 2024—The Society for Cardiovascular Angiography & Interventions (SCAI) advised that Aetna has removed two procedures from the insurer’s “experimental, investigational, or unproven” list in its policy update, effective August 15.

SCAI noted that along with the American College of Cardiology, Society of Interventional Radiology, Society for Vascular Surgery, and Outpatient Endovascular and Interventional Society, it has been advocating with Aetna to review their peripheral interventions policy, specifically as it relates to atherectomy.

The following items were removed:

• Atherectomy in combination with drug-coated balloon for treatment of femoropopliteal lesions
• The use of drug-eluting balloons for in-vein grafts and dialysis/vascular accesses, and for the treatment of primary lesion/occlusion of other peripheral arteries because its long-term effectiveness has not been established

Aetna has also informed SCAI that the company is working with eviCore to modify its clinical guidelines to indicate that atherectomy may be used as a standalone treatment modality for claudication and to clarify the application of atherectomy without stenting. These changes will be published in December.

Aetna’s policy update (available here) outlines the CPT codes for covered procedures and lists the procedures that remain on the “experimental, investigational, or unproven” list.

In the press release, SCAI applauded Aetna and eviCore’s decisions to expand their policy guidelines and stated it will continue to advocate for coverage of peripheral interventions.