Reimbursement claims and appeals

Carrier advocacy

SIR carrier advocacy workgroup prevents the enactment of interventional radiology coverage policies and abets modification of coverage policies that adversely affect SIR members. Our team develops evidence-based letters to help overturn carrier policy, denied authorizations, and denied claims.

IR Business Center

Evidence-based carrier coverage letters

The SIR carrier advocacy team found that carriers deny reimbursement to the physician or the patient for specific interventional radiology treatments. The society has developed evidence-based carrier advocacy letters to help overturn carrier policy, denied authorizations, denied claims, and garner support during peer-to-peer meetings with the payor. The carrier advocacy workgroup addresses urgent carrier advocacy issues by reviewing existing research and coverage gaps within specific policies. The carrier advocacy coverage letters can be found in the IR Business Center. The letters are free for SIR members and are provided in a PDF fillable format for you to view, edit, and print. Details on each letter are provided below.

Endometrial biopsy prior to uterine artery embolization (UAE)

Policy coverage topic: endometrial biopsy prior to uterine artery embolization (UAE) for the treatment of symptomatic uterine fibroids and adenomyosis

Endovascular arteriovenous fistula (EndoAVF)

Policy coverage topic: endovascular arteriovenous fistula (AVF) creation for the treatment of advanced chronic kidney disease (CKD) or end-stage renal disease (ESRD) anticipating or needing dialysis

Liver directed therapy (SIRT/TARE)

Policy coverage topic: selective internal radiation therapy (SIRT), also known as transarterial radioembolization (TARE), for the treatment of metastatic colorectal cancer to the liver

Ovarian and internal iliac vein embolization

Policy coverage topic: ovarian and internal iliac vein embolization for the treatment of pelvic venous disease, also known as pelvic congestion syndrome

Percutaneous bone cryoablation

Policy coverage topic: percutaneous bone cryoablation for the treatment of primary and metastatic bone tumor(s)

Percutaneous renal cryoablation

Policy coverage topic: percutaneous renal cryoablation for the treatment of solid renal masses and localized renal cancer

Prostate artery embolization (PAE)

Policy coverage topic: prostate artery embolization for the treatment of benign prostatic hyperplasia (BPH) treatments. Literature update 2024.

Pulmonary cryoablation

Policy coverage topic: percutaneous pulmonary cryoablation for the treatment of pulmonary tumor(s) Literature update 2024.

Uterine fibroid embolization (UFE) and uterine artery embolization (UAE)

Policy coverage topic: uterine fibroid embolization (UFE) and uterine artery embolization (UAE) for the treatment of uterine fibroids and adenomyosis
Policy coverage topic: Uterine artery embolization (UAE) for the treatment of endometriosis

Varicocele/gonadal embolization

Policy coverage topic: endovascular varicocele embolization for the treatment of testicular varicoceles

Venous angioplasty and stent placement

Policy coverage topic: venous angioplasty and stent placement for the treatment of acute iliofemoral thrombosis and chronic iliocaval occlusion and stenosis

Upcoming Letters:

Genicular artery embolization (GAE) for the treatment of osteoarthritis
Radiofrequency ablation (RFA) for the treatment of benign thyroid nodules
Yttrium-90 (Y-90) therapy for the treatment of hepatocellular carcinoma

Reimbursement claims and appeals

Reimbursement claims and appeals

Patient center

Member central

Advocacy

Corporate relations

Practice resources

Meetings and Education