LCD/NCD Portal

NCD20.2

 

EXTRACRANIAL-INTRACRANIAL (EC-IC) ARTERIAL BYPASS SURGERY

 

Effective Date of this Version

3/27/1991

 

Benefit Category

• Inpatient Hospital Services.

• Physicians' Services.

• Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

 

Indications and Limitations of Coverage

 

• Extracranial-Intracranial (EC-IC) arterial bypass surgery is not a covered procedure when it is performed as a treatment for ischemic cerebrovascular disease of the carotid or middle cerebral arteries, which includes the treatment or prevention of strokes.

• The premise that this procedure which bypasses narrowed arterial segments improves the blood supply to the brain and reduces the risk of having a stroke has not been demonstrated to be any more effective than no surgical intervention.

• Accordingly, EC-IC arterial bypass surgery is not considered reasonable and necessary within the meaning of §1862(a) (1) of the Act when it is performed as a treatment for ischemic cerebrovascular disease of the carotid or middle cerebral arteries.

 

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