Revised Claims & Payment Policy: Leg Stent Coding Updates

May 25, 2022

WellCare is reinforcing the prior auth review for Leg Stent Coding with an effective date as of July 1, 2022.

Summary of Policy:

WellCare is reminding providers to provide complete supporting clinical records, including clinical notes, for prior authorization requests for the following vascular codes, which require a medical necessity review.

What does this mean for providers?

Providers are currently required to submit all pertinent clinical records when submitting a prior authorization request for these 10 codes.  Providers can review the complete policy at: https://www.wellcare.com/Kentucky/Providers/Medicare/Claims/Payment-Policy