`C1743` Scafld endovas resrb drg elu

Scaffold, endovascular non-coronary, resorbable drug eluting, with delivery system (implantable)

Medicare coverage: Special coverage instructions apply
Status: active (October 2026 file)

Payer policies and prior authorization for C1743

Payer coverage policies that name C1743

C1743 appears in 2 coverage policies from Blue Cross & Blue Shield of Mississippi, Premera Blue Cross.

Payer	Policy	Role in policy	Reviewed	Document
Blue Cross & Blue Shield of Mississippi	Percutaneous Revascularization Procedures For Lower Extremity Peripheral Arterial Disease (A.7.01.178)	listed, no stance		payer document
Premera Blue Cross	Non-covered Experimental/Investigational Services Page \| 30 of 38 \| ∞	listed, no stance	Oct 1, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

ND: $0.00 (physician), effective Aug 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.

C1743 Scafld endovas resrb drg elu

Payer policies and prior authorization for C1743

Payer coverage policies that name C1743

Medicaid fee-for-service

`C1743` Scafld endovas resrb drg elu