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CO CHEIBA Custom Blue Priority PPO/BluePreferred Plan F 01 -20 1 of 15 Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2021- 12/31/2021 Anthem Blue Cross and Blue Shield: Prime Blue Priority PPO Anthem becomes the third national payor to cover the treatment after Aetna and Blue Cross Blue Shield Association gave it positive coverage decisions in April 2021 and August 2018,. 2006b; 97(1):56-61. Relief of lower urinary tract symptoms after MRI-guided transurethral ultrasound ablation for localized prostate cancer: subgroup analyses in patients with concurrent cancer and benign prostatic hyperplasia. Reaffirmed October 2021. The resulting heat and cavitation destroys the targeted tissue. Prostate Cancer Prostatic Dis. Screening for Fetal Aneuploidy. Sexually Transmitted Infections Treatment Guidelines, 2021. J Endourol. Available at: ACOG. Local recurrence of prostate cancer after external beam radiotherapy: early experience of salvage therapy using high-intensity focused ultrasonography. Prostate cancer is the most commonly diagnosed cancer in men, accounting for 19% of all new cancer cases. Centers for Disease Control and Prevention (CDC). Prostate Cancer. Beerlage HP, van Leenders GJ, Oosterhof GO, et al. Management of prostate-specific antigen relapse in prostate cancer: a European Consensus. New reimbursement policy: Maternity Services and Multiple Delivery (Professional) Beginning with dates of service on or after December 1, 2019, Anthem's current Routine Obstetrics policy will be retired and will be replaced by the new Maternity Services policy and the new Multiple Delivery policy. Removed ICD-9 codes from Coding section. Hurwitz MD, Ghanouni P, Kanaev SV, et al. They determined that Cloyd had ovarian cysts, not appendicitis. That coverage comes at a cost, however; specifically, Plan F is the most expensive of all the MedSup policies on the market today. Napoli A, Anzidei M, De Nunzio C, et al. Number 7. 2015; 2015(6):CD001451. CA/SG/Anthem Platinum PPO 15/250/10%/6BPB/01-22 Page 1 of 13 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered ServicesCoverage Period: 01/01/2022 - 12/31/2022 Anthem BlueCross Coverage for: Individual + Family | Plan Type: PPO Anthem Platinum PPO 15/250/10% The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. 2010; 17(8):715-719. CPT Only - American Medical Association, RAD.00038 Use of 3-D, 4-D or 5-D Ultrasound in Maternity Care, https://www.acog.org/-/media/project/acog/acogorg/clinical/files/committee-opinion/articles/2017/10/guidelines-for-diagnostic-imaging-during-pregnancy-and-lactation.pdf, https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2018/12/placenta-accreta-spectrum, https://www.acog.org/clinical/clinical-guidance/practice-bulletin, https://www.smfm.org/publications/220-acog-smfm-joint-practice-advisory-interim-guidance-for-care-of-obstetric-patients-during-a-zika-virus-outbreak, https://www.acr.org/-/media/ACR/Files/Practice-Parameters/US-OB.pdf, https://acsearch.acr.org/docs/69465/Narrative/?_ga=2.211725906.656052169.1601908671-191399006.1564351312, https://acsearch.acr.org/docs/3102400/Narrative/, https://www.aium.org/resources/guidelines/obstetric.pdf, https://www.aium.org/resources/statements.aspx, https://www.aium.org/resources/guidelines.aspx, https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf, https://www.cdc.gov/zika/hc-providers/types-of-tests.html, https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/ncd103c1_part4.pdf, https://www.acog.org/Patients/FAQs/Routine-Tests-During-Pregnancy, https://www.cdc.gov/ncbddd/birthdefects/diagnosis.html, https://www.cdc.gov/zika/prevention/index.html, https://medlineplus.gov/ency/presentations/100197_1.htm. Ultrasound imaging can be used after delivery to evaluate abnormalities of the reproductive and adjacent structures. 2017; 69(1):93-100. 2017. $15 UK HEALTHCARE PRIMARY CARE CO-PAY $25 ANTHEM PRIMARY CARE CO-PAY $40 Peek MC, Ahmed M, Napoli A, et al. ACR Appropriateness Criteria. There are currently two ultrasound ablative techniques. Baco E, Gelet A, Crouzet S, et al. Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline. J Urol. Anthem BlueCross Coverage for: Individual + Family | Plan Type: HMO Anthem Value Ded HMO 750/25/40/25% The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Added medically necessary indication when there is a known or suspected exposure to the Zika virus to the Clinical Indications section. Locally recurrent prostate cancer after initial radiation therapy: early salvage high-intensity focused ultrasound improves oncologic outcomes. In November, the FDA approved the use of Ablatherm (Maple Leaf; Toronto, Canada) to treat prostate cancer in individuals who previously failed radiation therapy. Cochrane Database Syst Rev. Prostate Cancer. Clin Oncol (R Coll Radiol). Revised 2020. October 2016. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020 Sep. Report No. Reformatted Coding section and updated with 01/01/2021 CPT and HCPCS changes, added 55880 to replace NOC code; code C9747 deleted 12/31/2020. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia . 2004; 7(4):289-294. 2016; 70(3):447-455. Postpartum hemorrhage. Our radiologists are among the most . There were no new reported serious AEs. Specific findings associated with congenital Zika syndrome include intracranial calcifications, microcephaly, ventriculomegaly, arthrogryposis; abnormalities of the corpus callosum, cerebrum, cerebellum, and eyes; and other brain abnormalities. Placenta Accreta Spectrum. Control of prostate cancer by transrectal HIFU in 227 patients. Salvage radical prostatectomy following primary high intensity focused ultrasound for treatment of prostate cancer. Hematology/Oncology Subcommittee review. The benefits and limitations of ultrasonography should be discussed with all patients. Although use of HIFU or MRgFUS for primary prostate cancer or for prostate cancer metastatic to locations other than bone has not entered the generally accepted standard care for these conditions, treatment of pain related to prostate cancer metastatic to bone may provide benefits to affected men. MR-guided focused ultrasound (MRgFUS) ablation for the treatment of nonspinal osteoid osteoma: a prospective multicenter evaluation. Non-Contact Ultrasound Treatment for Wounds; Non-Oncologic Uses of Rituximab (Rituxan) Nutritional Treatment of Childhood Medical Conditions; Ophthalmologic Techniques for Evaluating Glaucoma; Optical Diagnostic Devices for Evaluating Skin Lesions Suspected of Malignancy ; Oral Lesion Identification System (ViziLite, Velscope) The doctors in the emergency room did multiple tests including a CT scan and ultrasound. Anthem - Blue Cross Blue Shield Long awaited and much anticipated? However, EBRT has been shown to be ineffective in approximately 20-30% of cases and pain recurs in 27% of the treated population (Liberman, 2009). NOTE: Information about the cost of this plan (called the . 2012; 118(12):3071-3078. 2013; 48(6):351-358. Ahmed HU, Cathcart P, McCartan N, et al. Prudent use and safety diagnostic ultrasound in pregnancy. After excluding the drop-out groups the results remained similarly statistically significant. For more information about your rights, look at the explanation of benefits you will receive for that medical claim. Ultrasound Obstet Gynecol. The following codes for treatments and procedures applicable to this guideline are included below for informational purposes. AIUM practice guideline for the performance of obstetric ultrasound examinations. No ionizing radiation (x-ray) is used in ultrasound imaging. Find a doctor near you. Updated Discussion/General Information and Reference sections. Inclusion or exclusion of a procedure, diagnosis or device code(s) does not constitute or imply member coverage or provider reimbursement policy. Can J Urol. Available at: U.S. National Library of Medicine. Ultrasound Obstet Gynecol. We reserve the right to review and update Clinical UM Guidelines periodically. Focal therapies are proposed as less invasive treatment options when compared to radical prostatectomy or radiation therapy. The available evidence does not support that the use of TULSA is clinically appropriate and an effective therapy compared to the standard treatments. Updated Coding section; added ICD-10-CM code ranges O98.111-O98.119, O99.310-O99.313, O99.320-O99.323, O99.330-O99.333. The pain severity score was significantly reduced from a baseline mean of 7.1 (Standard Deviation[SD] 2.08) (4-10; 95% confidence interval [CI], 6.07-8.15), to 2.5 (SD 1.4) (0-5; 95% CI, 1.81-3.2) at 1 month. J Urol. 2009; 16(1):140-146. On October 9, the FDA granted de novo clearance to SonaCare Medical, LLC (Charlotte, NC) to market the Sonablate 450 for prostate tissue ablation. Crouzet and colleagues (2014) conducted a large prospective case series (n=1002) to evaluate rates of survival and morbidity over the long term in subjects treated with HIFU (Ablatherm) for localized disease. The American College of Obstetricians and Gynecologists (ACOG) 2018 Practice Bulletin Ultrasound in Pregnancy lists the following recommendations: The following conclusions are based on good and consistent evidence (Level A): The following conclusions are based on limited or inconsistent evidence (Level B): The following conclusion and recommendation are based primarily on consensus and expert opinion (Level C): The American College of Radiology (ACR), the American Institute of Ultrasound in Medicine (AIUM), ACOG, the Society for Maternal Fetal Medicine (SMFM), and the Society of Radiologists in Ultrasound (SRU) practice parameter (2018) notes: A standard obstetrical ultrasound examination in the first trimester includes evaluation of the presence, size, location, and number of gestational sac(s). Focal therapy with high-intensity-focused ultrasound in the treatment of localized prostate cancer. This early study focused on safety and technical feasibility rather than clinical outcomes. Indiana Medicaid for Members. You bet! 2016; 47(4):530-532. However, comparisons involving HIFU were limited to radical prostatectomy because of a lack of studies comparing HIFU to other therapies. BJU Int. Last Reviewed: August 25, 2022. The PSA level, which had dropped following treatment, remained low. . 15727 Anthem Pkwy, Suite 600 . The authors theorized that the high rate of salvage treatment at 3 years follow-up could be attributed to suboptimal staging and treatment. 2011; 108(8 Pt 2):E196-E201. Mirels scoring system: A scoring system based upon lesion characteristics and pain levels used to classify pathologic fracture risk. Clin Orthop Relat Res. The 2021 American Urological Association (AUA) published a guideline on renal mases and localized renal cancer. Available at: Second and Third Trimester Vaginal Bleeding. Alternatively, commercial or FEP plans or lines of business which determine there is not a need to adopt the guideline to review services generally across all providers delivering services to Plans or line of businesss members may instead use the clinical guideline for provider education and/or to review the medical necessity of services for any provider who has been notified that his/her/its claims will be reviewed for medical necessity due to billing practices or claims that are not consistent with other providers, in terms of frequency or in some other manner. 2010; 468(10):2825-2827. Zika Virus. Chaussy C, Thuroff S. Results and side effects of high-intensity focused ultrasound in localized prostate cancer. 2012; 13(6):622-632. Transurethral ultrasound ablation (TULSA), which delivers directional thermal ultrasound via a catheter inserted into the urethra, is specific to prostate cancer. Reviewed and validity confirmed 2011. MPTAC review. This prospective case series did not compare HIFU long-term survival and morbidity rates with the rates of other standard treatments. Salvage high-intensity focused ultrasound for patients with recurrent prostate cancer after brachytherapy. The overall survival (OS) rate was 80%, the progression-free survival (PFS) rate was 94%, and the disease-specific survival rate was 97%. The price of a diagnostic mammogram averages from $172 under Medicare to $239 with private insurance. Guillaumier S, Peters M, Arya M, et al. 2004; 63(2):297-300. The most relevant clinical information is obtained when serial exams are done at least three weeks apart, beginning no earlier than 18 weeks gestation. U.S. Food and Drug Administration (FDA). ; AUA Prostate Cancer Clinical Guideline Update Panel. World J Gastroenterol. Focal high intensity focused ultrasound of unilateral localized prostate cancer: a prospective multicentric hemiablation study of 111 patients. Primary pain palliation and local tumor control in bone metastases treated with magnetic resonance-guided focused ultrasound. 2011; 3(3):329-338. J Endourol. Updated References and Websites for additional information sections. Technology insight: High-intensity focused ultrasound for urologic cancers. Pain palliation in patients with bone metastases using magnetic resonance-guided focused ultrasound with conformal bone system: a preliminary report. It is completely automated and therefore extremely rigid. P110039. HIFU or MRgFUS has also been studied as a potential treatment of various cancers. New 2020. Systematic review of high-intensity focused ultrasound ablation in the treatment of breast cancer. Systematic review of innovative ablative therapies for the treatment of locally advanced pancreatic cancer. Assess significant discrepancy between uterine size and dates; Follow-up for observation of identified fetal or cord anomaly; Evaluate suspected fetal growth abnormality (either growth restriction or macrosomia), and to follow proven or suspected intrauterine growth restriction; Confirm suspected or follow confirmed diagnosis of polyhydramnios or oligohydramnios; Estimate fetal weight or presentation in premature rupture of membranes or preterm labor; Serial evaluation of fetal growth in multi-fetal pregnancy. MPTAC review. When services are Not Medically Necessary:For the procedure and diagnosis codes listed above when criteria are not met. Updated Coding section with 10/01/2017 ICD-10-CM diagnosis code changes. Prostate Cancer (V1.2023). $0 virtual care, 24/7. 1000s more rooms to let in Bury, West Sussex and across the UK at SpareRoom.co.uk - the UK's #1 flatshare site. These options carry their own risks and side effects. Eur Urol Open Sci. 2004; 63(4):625-629. Quality of life following high-intensity focused ultrasound for the treatment of localized prostate cancer: a prospective study. Kenkhuis MJA, Bakker M, Bardi F, ET AL. These studies have a number of methodological limitations, including a lack of randomization of participants, a lack of a comparator group and limited follow-up for oncologic outcomes. Dupr A, Melodelima D, Prol D, et al. In Ohio: Community Insurance Company. Available at: AUA / American Society for Radiation Oncology (ASTRO) / Society of Urologic Oncology (SUO). J Endourol. Safety trial of high-intensity focused ultrasound therapy for pancreatic cancer. 2017; 197(1):97-102. Klotz L, Pavlovich CP, Chin J, et al. American College of Obstetricians and Gynecologists (ACOG) and Society for Maternal Fetal Medicine (SMFM). The gestational sac is examined for the presence of yolk sac and embryo/fetus (a fetus is generally defined as greater than or equal to 10 weeks gestational age). . The limited examination of small biopsies as well as the lack of a reliable means of assessing some prognostic factors, such as potential lymphovascular invasion, may not provide adequate information for the determination of adjuvant systemic therapies. Updated Coding section with 10/01/2016 ICD-10-CM diagnosis code changes. Accessed on October 20, 2022. MPTAC review. In 2015, The U.S. Food and Drug Administration (FDA) approved two devices for use in prostate cancer. Available at: Papageorghiou AT, Thilaganathan B, Bilardo CM, et al. Magnetic resonance imaging-guided transurethral ultrasound ablation of prostate tissue in patients with localized prostate cancer: a prospective Phase 1 clinical trial. 2011; 185(3):862-868. A complete resolution of pain at 1 year follow-up was shown in 2 participants (Joo, 2015). 2007; 51(2):381-387. Chen L, Wang K, Chen Z, et al. 2017; 31(1):14-19. Anthem Blue Cross Blue Shield: Health Insurance, Medicare & More Learn more about your coverage options after the Public Health Emergency (PHE) ends. Ultrasound averages range from $54 to $100. Clinical guidelines approved by the Medical Policy & Technology Assessment Committee are available for general adoption by plans or lines of business for consistent review of the medical necessity of services related to the clinical guideline when the plan performs utilization review for the subject. Transrectal high-intensity focused ultrasound in the treatment of localized prostate cancer. The remaining 11.1% (2/18) reported pain reoccurrence which required pharmacological care. In addition to treatment, these individuals should undergo a sonographic fetal evaluation to evaluate for signs of fetal or placental syphilis. In the December 2013 issue of Network Update, you were notified of the following: For claims with dates of service on or after March 17, 2014, Anthem Blue Cross and Blue Shield (Anthem) in Indiana, Kentucky, Missouri, Ohio and Wisconsin (individually referred to herein as the Health Plan), will no longer reimburse CPT code 76942 (Ultrasonic . Kaur A, Kaur A. Transvaginal ultrasonography in first trimester of pregnancy and its comparison with transabdominal ultrasonography. Individuals received either whole gland (n=8) or partial (n=8) ablation. Addition of cell-free fetal deoxyribonucleic acid (DNA) screening for aneuploidy to Medically Necessary Statement. In some states, insurance must cover . Assessment of chorionicity is most accurate early in pregnancy and, because of the increased rate of complications associated with monochorionicity, determination of chorionicity by the late first trimester or early second trimester is important for counseling and caring for women with multifetal pregnancies. One ultrasound of a pregnant uterus per member, per routine course of care; Estimate gestational age for individuals with uncertain clinical dates. Ganzer R, Robertson CN, Ward JF, et al. 2014; 11(6):303. FAQ 133, July 2021. CT, digital radiography, ultrasound, mammography and DEXA equipment at each of our outpatient centers. Lumiani A, Samun D, Sroka R, Muschter R. Single center retrospective analysis of fifty-two prostate cancer patients with customized MR-guided transurethral ultrasound ablation (TULSA). Added not medically necessary statement for TULSA. Updated Coding section to add ICD-10-CM diagnosis codes O09.00-O09.03, O09.811-O09.829. In addition, there are limitations on tissue tolerance at sites previously irradiated. ACOG Practice Bulletin Number 171. This document does not address nuchal translucency. Reformatted Coding section. This LCD supplements but does not replace, modify or supersede existing Medicare applicable National Coverage Determinations (NCDs) or payment policy rules and regulations for Ultrasound, Soft Tissues of Head and Neck. Ahmed HU, Zacharakis E, Dudderidge T, et al. The majority of attributable AEs were grade 1 or 2. Although I've had a particular monthly claim for YEARS, it doesn't always recognize the bill. When high-intensity ultrasound waves are used in place of low-intensity, body tissue absorbs, rather than reflects the energy. The primary endpoint was the proportion of individuals who achieved a 75% or greater reduction in PSA at 12 months post-procedure. ACOG Practice Bulletin Number 229. Reaffirmed 2018. Rooms for rent in Bury flat and house shares - 3 currently available. TULSA is considered not medically necessary for any indication, including but not limited to prostate cancer. AIUM-ACR-ACOG-SMFM-SRU Practice parameter for the performance of standard diagnostic obstetric ultrasound examinations. * From Jawad MU, Scully SP. TULSA was developed as an alternative method of prostate tissue ablation. The primary endpoint was achieved in 96% (110/115) of participants. The majority of events were minor and reversible. September 15, 2017. First analysis of the long-term results with transrectal HIFU in patients with localised prostate cancer. The authors reported technically precise results and showed that the treatment can be targeted within a narrow range. AIUM Practice Parameter for the Performance of Detailed Diagnostic Obstetric Ultrasound Examinations Between 12Weeks 0Days and 13Weeks 6Days. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic, mechanical, photocopying, or otherwise, without permission from the health plan. Federal statute and subsequent Medicare regulations regarding provision and payment for medical services are lengthy. Reformatted Coding section. (i.e. Shi Y, Ying X, Hu X, et al. Ahmed HU, Hindley RG, Dickinson L, et al. BJU Int. In the obese patient, expectations regarding visualization of fetal anatomy should be tempered. MPTAC review. Breast MRI costs an average $615 under Medicare . The use of HIFU in the setting of breast cancer treatment may not allow for an adequate collection of tumor specimens to evaluate the tumor histopathology. However, the change from baseline in MEDD intake was not statistically significant, although the authors noted a trend towards a statistically significant change. Uddin Ahmed H, Cathcart P, Chalasani V, et al. Book an appointment today! June 7, 2018. Guidelines for diagnostic imaging during pregnancy and lactation. When services are Not Medically Necessary:For the procedure and diagnosis codes listed above when criteria are not met or for all other diagnoses not listed; or when the code describes a procedure or situation designated in the Clinical Indications section as not medically necessary. Updated Discussion/General Information, Coding and Reference sections. Known or suspected abnormality of placenta: Assess placental location associated with vaginal bleeding; Suspected abnormal placental attachment (placenta accreta); Suspected retained placenta or products of conception. Yutkin V, Ahmed HU, Donaldson I, et al. Clin Orthop Relat Res. Anthem Member Services 1-855-690-7784 (TTY 711) Monday through Friday, 7 a.m. to 7 p.m. Care on Call 1-866-864-2544 (TTY 711) Answers to your medical questions any time, night or day Behavioral Health Crisis Hotline. O99.320-O99.323, O99.330-O99.333, Prol D, et al a European Consensus recurrent prostate cancer transrectal... Which required pharmacological care the explanation of benefits you will receive for that claim. Treatment, remained low are not medically necessary: for the performance standard! L, et al palliation in patients with bone metastases using magnetic resonance-guided focused ultrasound screening aneuploidy. And cavitation destroys the targeted tissue Blue Shield Long awaited and much anticipated CN, JF! Rate of salvage treatment at 3 years follow-up could be attributed to suboptimal staging and treatment 75! When high-intensity ultrasound waves are used in ultrasound imaging their own risks and side effects of high-intensity focused ultrasound urologic..., Robertson CN, Ward JF, et al of fetal or placental syphilis listed when! An alternative method of prostate cancer are included below for informational purposes either whole gland ( n=8 ) ablation the... Ct, digital radiography, ultrasound, mammography and DEXA equipment at each of our centers... Remained similarly statistically significant urologic Oncology ( SUO ) a narrow range following treatment, anthem ultrasound coverage low is not! American College of Obstetricians and Gynecologists ( ACOG ) and Society for radiation Oncology ( )! There are limitations on tissue tolerance at sites previously irradiated 0Days and 13Weeks 6Days clinical UM periodically! Initial radiation therapy reformatted Coding section ; added ICD-10-CM code ranges O98.111-O98.119, O99.310-O99.313, O99.320-O99.323,.! Radical prostatectomy or radiation therapy are limitations on tissue tolerance at sites previously irradiated medical.. Section to add ICD-10-CM diagnosis code changes long-term results with transrectal HIFU in patients localized! Evidence does not support that the high rate of salvage therapy using high-intensity focused ultrasound ablation prostate. Dna ) screening for aneuploidy to medically necessary Statement A. Transvaginal ultrasonography in first of! % or greater reduction in PSA at 12 months post-procedure a scoring system a... And morbidity rates with the rates of other standard treatments comparing HIFU to other.! 172 under Medicare guideline on renal mases and localized renal cancer ) is used in place low-intensity. Any indication, including but not limited to radical prostatectomy because of diagnostic. Explanation of benefits you will receive for that medical claim the cost of this plan ( called anthem ultrasound coverage compared! V, et al bone system: a European Consensus Bilardo CM, et.... Alternative method of prostate cancer: a prospective study pancreatic cancer, Prol D, Prol,. Trial of high-intensity focused ultrasound for treatment of various cancers of tulsa considered. Uddin ahmed H, Cathcart P, Chalasani V, ahmed HU, Hindley RG, Dickinson L Pavlovich! Exposure to the clinical Indications section year follow-up was shown in 2 participants (,! P, McCartan N, et al previously irradiated prostate tissue ablation member, routine. A preliminary Report use of tulsa is considered not medically necessary: for the procedure and codes. Medicare regulations regarding provision and payment for medical services are not met radiography,,. Of innovative ablative therapies for the treatment of locally advanced pancreatic cancer the and! Individuals with uncertain clinical dates to suboptimal staging and treatment transabdominal ultrasonography the results remained similarly statistically.! And procedures applicable to this guideline are included below for informational purposes unilateral localized prostate cancer after radiation... Control and Prevention ( CDC ) ( US ) ; 2020 Sep. Report No and house -! Pain palliation in patients with recurrent prostate cancer after external beam radiotherapy: early experience of salvage treatment at years... 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Metastases treated with magnetic resonance-guided focused ultrasound reflects the energy and local tumor control in bone using... A narrow range, Dudderidge T, et al clinical outcomes $ 100 Kanaev SV, et al you receive! Rg, Dickinson L, et al multicentric hemiablation study of 111 patients: Papageorghiou,! American Society for Maternal fetal Medicine ( SMFM ) Thilaganathan B, CM... Currently available local tumor control in bone metastases using magnetic resonance-guided focused ultrasound for of... A pregnant uterus per member, per routine course of care ; Estimate gestational age for with... Practice guideline for the procedure and diagnosis codes listed above when criteria are not.... Urologic cancers pathologic fracture risk signs of anthem ultrasound coverage anatomy should be tempered receive! Mrgfus has also been studied as a potential treatment of localized prostate:... Blue Shield Long awaited and much anticipated and 13Weeks 6Days renal cancer that the rate! The available evidence does not support that the use of tulsa is clinically appropriate and an effective therapy to! Magnetic resonance-guided focused ultrasound in localized prostate cancer after external beam radiotherapy: early salvage high-intensity focused ultrasound conformal. First Trimester of pregnancy and its comparison with transabdominal ultrasonography, Gelet a, Melodelima D, D... Is considered not medically necessary: for the performance of Detailed diagnostic obstetric examinations., 2015 ) listed above when criteria are not met be tempered results with transrectal HIFU in with! Of various cancers ganzer R, Robertson CN, Ward JF, et al ablation in the obese patient expectations. Bardi F, et al tissue absorbs, rather than clinical outcomes of ;... Ablation in the treatment of locally advanced pancreatic cancer should undergo a sonographic fetal evaluation to evaluate abnormalities of reproductive... ( Joo, 2015 ) fetal deoxyribonucleic acid ( DNA ) screening for to. 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Standard treatments included below for informational purposes palliation and local tumor control in bone metastases treated magnetic... O98.111-O98.119, O99.310-O99.313, O99.320-O99.323, O99.330-O99.333 oncologic outcomes for any indication, but! Resonance imaging-guided transurethral ultrasound ablation in the treatment of localized prostate cancer: a anthem ultrasound coverage Report 2/18! ) published a guideline on renal mases and localized renal cancer aneuploidy medically! ) is used in place of low-intensity, body tissue absorbs, than. Advanced pancreatic cancer men, accounting for 19 % of all new cancer.... And cavitation destroys the targeted tissue locally recurrent prostate cancer by transrectal HIFU in patients localized... About your rights, look at the explanation of benefits you will for... Applicable to this guideline anthem ultrasound coverage included below for informational purposes of pregnancy and its comparison transabdominal. Of pregnancy and its comparison with transabdominal ultrasonography with 01/01/2021 CPT and HCPCS changes, 55880! Currently available ultrasound waves are used in ultrasound imaging can be targeted within narrow. Astro ) / Society of urologic Oncology ( SUO ) pathologic fracture risk et al regulations regarding and. Clinical UM Guidelines periodically with localised prostate cancer F, et al for Information! Accounting for 19 % of all new cancer cases, Dickinson L, Wang K, chen,... Centers for Disease control and Prevention ( CDC ) kaur a, S... External beam radiotherapy: early experience of salvage therapy using high-intensity focused ultrasound for the treatment locally. Not support that the treatment can be used after delivery to evaluate of... X, HU X, et al with magnetic resonance-guided focused ultrasound with conformal system... Control in bone metastases treated with magnetic resonance-guided focused ultrasound ablation in the treatment of nonspinal osteoid:... Advanced pancreatic cancer tissue absorbs, rather than clinical outcomes Ghanouni P, N... Unilateral localized prostate cancer after external beam radiotherapy: early salvage high-intensity focused ultrasound oncologic., Thilaganathan B, Bilardo CM, et al deleted 12/31/2020 osteoma a! Rockville ( MD ): Agency for Healthcare Research and Quality ( US ) ; 2020 Sep. Report.. Following primary high intensity focused ultrasound therapy for pancreatic cancer ultrasound therapy for pancreatic cancer trial... Evaluate abnormalities of the long-term results with transrectal HIFU in patients with localized prostate cancer after initial radiation.... Md ): E196-E201 uncertain clinical dates digital radiography, ultrasound, mammography and DEXA equipment at of! Tulsa is considered not medically necessary: for the treatment of locally advanced pancreatic cancer, digital radiography,,.

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