Request Prior Approval of Carotid Stenting Coverage
Diagnosis Code(s) (if known): ... clinical guideline . based data collection tool is for . requesting . a medical necessity review for . extracranial (cervical) carotid, vertebral and intracranial artery stent placement with or without angioplasty. ... There is NO visible intraluminal thrombus on angiography. Individual has . complete occlusion ... ................
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