37242 coverage policies: Medicare and commercial payers

3 active Medicare policies list 37242, and 16 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.

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Medicare policies listing 37242

LCD · PALMETTO-JJ-L40228

Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities

JJ · Effective Apr 12, 2026

LCD · PALMETTO-JM-L40228

Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities

JM · Effective Apr 12, 2026

Article · A60247

Billing and Coding: Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities

National · Effective Apr 12, 2026

Commercial payer policies listing 37242

16 policies from 8 payers

Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.

Aetna

Aetna policies listing 37242, with the code’s status in each
Policy	Effective	Status of 37242
Ablation of Hepatic LesionsPayerPolicy · AETNA-CPB-0274	Nov 9, 2023	Covered
Benign Prostatic HyperplasiaPayerPolicy · AETNA-CPB-0079	Feb 8, 2024	Covered
Knee Arthroscopy / Osteoarthritis of the KneePayerPolicy · AETNA-CPB-0673	Nov 21, 2023	Covered

Anthem

Anthem policies listing 37242, with the code’s status in each
Policy	Effective	Status of 37242
Bariatric Surgery and Other Treatments for Clinically Severe ObesityClinical Guideline · ANTHEM-CG-SURG-83	Oct 1, 2026	Covered
Genicular Procedures for Treatment of Knee PainPayerPolicy · ANTHEM-SURG.00142

Policy	Effective	Status of 37242
Cigna Commercial Vascular Interventions Code ListPayerPolicy · EVICORE-HPLAN-CIGNA-C1ABE2E60ED3	Mar 7, 2026	Prior auth required
Cigna Comprehensive Code ListPayerPolicy · EVICORE-HPLAN-CIGNA-1766449955E6	Mar 7, 2026	Prior auth required

37242 coverage policies: Medicare and commercial payers

Medicare policies listing 37242

Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities

Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities

Billing and Coding: Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities

Commercial payer policies listing 37242

Aetna

Anthem

37242 coverage policies: Medicare and commercial payers

Medicare policies listing 37242

Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities

Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities

Billing and Coding: Endovascular Management for Peripheral Arterial Disease of the Upper and Lower Extremities

Commercial payer policies listing 37242

Aetna

Anthem

BCBS Illinois

BCBS Montana

BCBS New Mexico

BCBS Oklahoma

Cigna

Carelon Medical Benefits Management

Policy	Effective	Status of 37242
Genicular Artery EmbolizationPayerPolicy · BCBSIL-SUR705.048	Jul 15, 2025	Covered
Therapeutic Embolization and Vessel Occlusion to Treat Pelvic ConditionsPayerPolicy · BCBSIL-SUR701.015	Jan 1, 2026	Covered