Sean P. Lyden, MD, chairman of the Department of Vascular Surgery at Cleveland Clinic’s Heart, Vascular and Thoracic Institute in Cleveland, Ohio, will discuss the national coverage determination (NCD) changes passed by the Centers for Medicare & Medicaid Services (CMS) on carotid artery stenting (CAS) during the 2024 Vascular Annual Meeting (VAM).
His presentation—part of the Contemporary Management of Carotid Disease After the Coverage Decision Change and Prior to CREST-2 Results session on Friday, June 21, at 1:30 p.m. (West Building, Level 1)—will address new options and responsibilities for clinicians and health systems in light of these updates.
Lyden will highlight new data covering transfemoral carotid stenting and new technologies since the last NCD. He will emphasize how the updated NCD equates transfemoral CAS and transcarotid artery revascularization (TCAR) with carotid endarterectomy (CEA) for Medicare reimbursement. This change has expanded coverage to include symptomatic patients with 50% or greater stenosis and asymptomatic patients with 70% or greater stenosis.
Last year, Vascular Specialist reported how nearly one-third of the public comments submitted to CMS on the then proposed coverage decision affecting carotid stenting were from SVS members. Of approximately 760 responses, at least 237 were initially identified as being from SVS members. In October, CMS released its final decision regarding NCD 20.7, covering CAS, essentially confirming the coverage expansion outlined in a July proposed decision memo.
