Part B Insider (Multispecialty) Coding Alert
CMS Throws The Brakes On Expanding Your CAS Payments
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The only hope for many patients: clinical trials
You can stop looking out for asymptomatic patients who could benefit from carotid artery stenting (CAS).
The Centers for Medicare & Medicaid Services (CMS) had proposed to expand coverage for CAS to patients with 80 percent or greater carotid artery stenosis, even if they had no symptoms. (See PBI, Vol., 8, No. 5.) Providers had cheered this proposal, saying it reflected a realization that CAS is a less invasive treatment that can help many patients.
But CMS just changed its mind. The agency announced that it would keep its current coverage criteria for CAS, instead of expanding coverage. Medicare will cover CAS for patients who are at high risk for carotid endarectomy and who have symptomatic stenosis of 70 percent or more. CMS will also cover CAS for patients in some clinical trials.
Why? CMS noted that it's already expanded CAS coverage three times in the past six years.
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