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Printer Friendly Version Excimer Laser Coronary Angioplasty (ELCA)

Excimer Laser Coronary Angioplasty (ELCA)

 

DESCRIPTION

In the 1980s, excimer laser angioplasty was developed as an alternative method of percutaneous angioplasty, with the objective of reducing the high rate of restenosis associated with other angioplasty or stenting techniques.   Excimer laser coronary angioplasty (ELCA) is a procedure that utilizes an intravascular catheter system to deliver high-energy laser light to atherosclerotic lesions that are causing stenosis or occlusion of native coronary arteries, vein grafts placed at previous coronary artery bypass surgery, or stainless steel intracoronary stents, while producing relatively little thermal damage to the vessel wall. ELCA is usually performed in combination with balloon angioplasty and is intended as a minimally invasive alternative to open surgical revascularization for patients with atherosclerotic coronary lesions.

 

POLICY

Excimer laser coronary angioplasty (ELCA) for the treatment of atherosclerotic lesions that are causing stenosis or occlusion of native coronary arteries, vein grafts placed at coronary artery bypass surgery, or stainless steel intracoronary stents is considered investigational.

 

POLICY EXCEPTIONS

None

 

POLICY GUIDELINES

Investigative service is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized by certifying boards and/or approving or licensing agencies or published peer review criteria as standard, effective medical practice for the treatment of the condition being treated and as such therefore is not considered medically necessary.

The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.

 

POLICY HISTORY

8/2002: Approved by Medical Policy Advisory Committee (MPAC)

12/19/2003: Code Reference section completed

10/16/2006: Policy reviewed, no changes

 

SOURCE(S)

Hayes Medical Technology Directory

 

CODE REFERENCE

All codes billed are considered investigational   and not eligible for coverage.  

Non-Covered Codes

Code Number
Description

CPT-4

93799

Unlisted cardiovascular service or procedure

ICD-9 Procedure

39.59

Other repair of vessel

ICD-9 Diagnosis

 

 

HCPCS

 

 

 

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