37254 coverage policies: Medicare and commercial payers

6 active Medicare policies list 37254, and 11 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 37254

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

LCD · WPS-J5-L35998

Non-Coronary Vascular Stents

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L35998

Non-Coronary Vascular Stents

J8 · Effective Oct 1, 2015

Article · A60247

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

National · Effective Apr 12, 2026

Article · A57590

Billing and Coding: Non-Coronary Vascular Stents

J5 · Effective Jan 1, 2026

Commercial payer policies listing 37254

11 policies from 10 payers

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

Cigna

Cigna policies listing 37254, with the code’s status in each
Policy	Effective	Status of 37254
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

Aetna

Aetna policies listing 37254, with the code’s status in each
Policy	Effective	Status of 37254
Aetna Vascular Intervention Code ListPayerPolicy · EVICORE-HPLAN-AETNA-9B48480FF601	Jan 1, 2026	Prior auth required

BCBS Illinois

37254 coverage policies: Medicare and commercial payers

Medicare policies listing 37254

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

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

Non-Coronary Vascular Stents

Non-Coronary Vascular Stents

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

Billing and Coding: Non-Coronary Vascular Stents

Commercial payer policies listing 37254

Cigna

Aetna

BCBS Illinois

37254 coverage policies: Medicare and commercial payers

Medicare policies listing 37254

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

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

Non-Coronary Vascular Stents

Non-Coronary Vascular Stents

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

Billing and Coding: Non-Coronary Vascular Stents

Commercial payer policies listing 37254

Cigna

Aetna

BCBS Illinois

BCBS Montana

BCBS New Mexico

BCBS Oklahoma

Carelon Medical Benefits Management

Surest (UnitedHealthcare)

UMR (UnitedHealthcare)

UnitedHealthcare