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The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. 
You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101. 
 
The rules state that stenting of vessels is covered only when all of the following conditions are met: 
 
    Angioplasty alone would not suffice. 
    The patient has undergone prior thorough medical evaluation and management of symptoms for which PTA 
and stent are therapeutic. 
    Surgical intervention would otherwise be considered as an alternative treatment for the patient. 
    Condition(s) exists for which there is evidence of equal outcomes with renal artery intervention and medical 
therapy when compared with outcome of medical or surgical management. 
 
You can find this information in the Local Coverage Determination (LCD) Non-Coronary Vascular Stents 
L35084. 
 
This procedure involves inserting a balloon catheter into a narrow or occluded blood vessel to recanalize and 
dilate the vessel by inflating the balloon. The objective of percutaneous transluminal angioplasty (PTA) is to 
improve the blood flow through the diseased segment of a vessel so that vessel patency is increased and 
embolization is decreased. With the development and use of balloon angioplasty for treatment of 
atherosclerotic and other vascular stenoses, PTA (with and without the placement of a stent) is a widely used 
technique for dilating lesions of peripheral, renal, and coronary arteries. 
 
National Coverage Determination (NCD) Percutaneous Transluminal Angioplasty (PTA) 20.7. 
  
Covered Indications 
 
    Medical Necessity for Abdominal Aortography/Angiography 
        Acute traumatic abdominal injury 
        Aneurysm and other primary vascular abnormalities 
        Occlusive disease, including evaluation for acute or chronic intestinal ischemia 
        Acute GI hemorrhage 
        Congenital anomaly 
        Prior to arterial interventional procedures or open surgical procedures 
    Medical Necessity for Stand-Alone Renal Angiography 
        Severe or difficult to control renal hypertension 
            for severe or difficult to control renal hypertension, OR             progressive renal insufficiency, OR 
            resistant hypertension 
        Renal neoplasm 
        Hematuria of unknown cause 
        Abnormal kidney imaging involving radioisotopes 
        Renal artery stenosis, aneurysm, trauma, or other intrinsic defects prior to renal arterial intervention 
    Medical Necessity for Lower Extremity or Renal Angiography done at the same time as a different 
interventional procedure (for example, cardiac catheterization with coronary angiography) 
 
    Diagnostic renal angiography or lower extremity angiography performed at the time of an interventional 
procedure is separately reportable if at least one indication for medical necessity for a stand-alone lower 
extremity or renal angiography is met AND one of the following are also met: 
        No prior catheter-based angiographic study is available and a full diagnostic study is performed, and the 
decision to intervene is based on the diagnostic study, OR 
        A prior study is available, but as documented in the medical record: 
            The patients condition with respect to the clinical indication has changed since the prior study; OR 
            There is inadequate visualization of the anatomy or pathology; OR 
            There is a clinical change during the interventional procedure that requires new evaluation outside the 
target area of intervention. 
    Medical necessity for a Stand-Alone Lower Extremity Angiography must be documented by pre-procedure 
clinical assessment. This assessment should include the following: 
        Documentation that an invasive intervention is planned, AND 
        Documentation that a prior non-invasive study was completed and indicates further study is needed by 
angiography for the planned intervention, AND 
        Documentation of one of the following conditions: arterial embolism, acute or chronic ischemia, 
peripheral vascular disease (includes claudication), or aneurysm. 
 
You can find this information in the Local Coverage Determination (LCD) Diagnostic Abdominal Aortography 
and Renal Angiography L35092. 
 
If you want to read these Medicare rules, you can go to this website www.medicareappeal.com.