Thuroff S, Chaussy C, Vallancien G, et al. Eur Urol. Transurethral ultrasound ablation (TULSA), which delivers directional thermal ultrasound via a catheter inserted into the urethra, is specific to prostate cancer. The authors concluded, Although newer modalities hold promise, we need higher quality studies to assess patient important outcomes to guide evidence-based clinical practice.. Cochrane Database Syst Rev. When high-intensity ultrasound waves are used in place of low-intensity, body tissue absorbs, rather than reflects the energy. Ultrasound is currently being used as a therapeutic treatment, for example, lithotripsy to disintegrate kidney stones. Uddin Ahmed H, Cathcart P, Chalasani V, et al. In brief: classifications in brief: Mirels' classification: metastatic disease in long bones and impending pathologic fracture. Pain palliation for localized metastatic bone pain. ACOG Practice Bulletin Number 183, October 2017. Sonablate was classified as a class II device. At 12 months, the majority of participants (10/11) were cancer free in the ablated area and maintained a low stable PSA. 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. Crouzet S, Murat FJ, Pommier P, et al. Insurance coverage for whole-breast ultrasound is evolving. Accessed on October 20, 2022. 2014; 20(28):9570-9577. Available at: American Institute of Ultrasound in Medicine (AIUM). The routine use of pulsed Doppler ultrasound to either document or listen to embryonic/fetal cardiac activity is discouraged. 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) Shi Y, Ying X, Hu X, et al. National Coverage Determination: Ultrasound diagnostic procedures. 2017; 120(2):246-256. Thuroff S, Chaussy C. High-intensity focused ultrasound: complications and adverse events. Update date: March 4, 2022. Klotz L, Pavlovich CP, Chin J, et al. Adult Cancer Pain (V2.2022). Int J Urol. Kaur A, Kaur A. Transvaginal ultrasonography in first trimester of pregnancy and its comparison with transabdominal ultrasonography. Approximately 30% of all individuals with cancer develop metastatic bone lesions and 50-75% of these individuals report significant pain. Real-time magnetic resonance-guided high-intensity focused ultrasound focal therapy for localised prostate cancer: preliminary experience. The Centers for Medicare and Medicaid Services (CMS) released an updated Relative Value file Jan. 5, that includes updated reimbursement for the neuromuscular ultrasound codes 76881, 76882 and 76883. 2018; 30(4):233-242. Bone metastases are common in breast and prostate cancer (Liberman, 2009). HIFU was comparable to the median survival in standard chemotherapy. Urology. December 2016. 2021; 205(3):769-779. Int J Urol. Pain palliation in patients with bone metastases using MR-guided focused ultrasound surgery: a multicenter study. MPTAC review. Updated Discussion/General Information, References and Websites for Additional Information sections. We have 53 properties for rent listed as: house bury, from 520.Find: bury properties for rent at the best prices We use cookies to personalize your Trovit experience on our site, analyze. But in general, know that most plans cover: STD testing; Rh incompatibility testing; Prenatal vitamins; Gestational diabetes testing; Breastfeeding counseling and equipment; Post-birth birth control; Birth; Medical coverage of any complications; Dependent Care Accounts For other common visits, this is what you'll pay with PPO. However, the change from baseline in MEDD intake was not statistically significant, although the authors noted a trend towards a statistically significant change. 1999b; 39(1):41-46. CPT codes Dx codes 76801 76802 D25, D25.0, D25.1, D25.2, D25.9, O0900, O0901, O0902, O0903, O09511, O09512, High-intensity focused ultrasound (HIFU) followed after one to two weeks by radical retropubic prostatectomy: results of a prospective study. Napoli A, Anzidei M, De Nunzio C, et al. TULSA was developed as an alternative method of prostate tissue ablation. Zika Virus. The maternal cervix and adnexa should be examined. MR-guided focused ultrasound (MRgFUS) ablation for the treatment of nonspinal osteoid osteoma: a prospective multicenter evaluation. Eur Urol. The majority of events were minor and reversible. Ultrasound examinations, particularly if obtained soon after onset of infection, may not identify prenatal features of congenital Zika syndrome and structural manifestations can be identified at later points in pregnancy. Transrectal high-intensity focused ultrasound in the treatment of localized prostate cancer: a multicenter study. Contact us today for information about Anthem or for questions regarding Medicaid programs and coverage. 2021. In addition, there are limitations on tissue tolerance at sites previously irradiated. Hemi salvage high-intensity focused ultrasound (HIFU) in unilateral radiorecurrent prostate cancer: a prospective two-centre study. Updated Coding section with 10/01/2020 ICD-10-CM changes; added O99.891; removed Q51.20 deleted 09/30/2020. AIUM Practice Parameter for the Performance of Limited Obstetric Ultrasound Examinations by Advanced Clinical Providers. Muto S, Yoshii T, Saito K, et al. CA/LG/Anthem PPO HSA/H 2000/3000/4000 20/40/73A3/01-23 Page 1 of 11 Summary of Benefits and Coverage: What this Plan Covers & What You Pay for Covered Services Anthem BlueCross Coverage for: Individual + Family | Plan Type: PPO + Anthem PPO HSA/H 2000/3000/4000 20/40 HSA . If maternal testing does not suggest infection, patients should receive the same ultrasound screening as any other pregnant woman as part of standard routine prenatal care. As of January 10, 2022, through January 31, 2022, Anthem and its delegated entities will suspend select prior authorization requirements to allow healthcare providers to focus on caring for patients diagnosed with COVID-19. Guillaumier S, Peters M, Arya M, et al. Please refer to the member's contract benefits in effect at the time of service to determine coverage or non-coverage of these services as it applies to an individual member. Prostate cancer is the most commonly diagnosed cancer in men, accounting for 19% of all new cancer cases. Updated Discussion/General Information and Reference sections. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020 Sep. Report No. Eur Urol. Prostate cancer therapy with high-intensity focused ultrasound. Clin Oncol (R Coll Radiol). Available at: ACOG. Salvage high-intensity focused ultrasound for patients with recurrent prostate cancer after brachytherapy. 2003; 17(8):673-677. 2014; 84(5):1157-1162. Li CC, Wang YQ, Li YP, Li XL. 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 . Salvage magnetic resonance imaging-guided transurethral ultrasound ablation for localized radiorecurrent prostate cancer: 12-month functional and oncological results. 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. Before you decide to pass on Plan F, though, do your due diligence and see how much the insurance . Management of preterm labor. The use of high intensity focused ultrasound (HIFU) is considered medically necessary for pain palliation in individuals with localized metastatic bone pain when all the following criteria are met: High intensity focused ultrasound (HIFU) is considered not medically necessary when the above criteria are not met and for all other indications, including but not limited to, the treatment of prostate cancer. Eur Urol. J Urol. In a systematic review, Li and colleagues (2014) performed a meta-analysis on the use of HIFU in combination with radiotherapy or chemotherapy in the treatment of pancreatic cancer. close combat footage enemy visible bungee fitness dickson tn Tue, Oct 18 2022 Practice Advisory Interim Guidance for Care of Obstetric Patients During a Zika Virus Outbreak. FAQ 133, July 2021. The document header wording updated from Current Effective Date to Publish Date. Updated Discussion/General Information, References and Websites for Additional Information sections. Available at: Testing for Zika Virus Infections. Available at: U.S. National Library of Medicine. 2012; 116(3):201-205. HIFU treatment is combined with a visualization method, frequently MR guidance, to better guide treatment in real time. Anttinen M, Mkel P, Viitala A, et al. Eur Urol. When services are Not Medically Necessary:For the procedure and diagnosis codes listed above when criteria are not met. 2000; 4(3):183-187. 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. Anthem has stopped covering patients in nine states 1 for MRI and CT scans performed in hospital outpatient settings - unless the exam qualifies for an "exception." On Nov. 15, Anthem will start retroactive reviews of MRI and/or CT services done in emergency departments in Missouri, Ohio and Kentucky. Available at: High Intensity Ultrasound System For Prostate Tissue Ablation (Focal One). Urology. Known or suspected abnormality of maternal reproductive structure: Clinical suspicion of cervical insufficiency (for example, abnormal cervix on physical examination, maternal history of second trimester pregnancy loss, prior cervical surgery, and diethylstilbestrol [DES] exposure); To assess cervical length in the second or third trimester in individuals with a history of one or more pregnancy losses in the second or early third trimester or in individuals who have had preterm labor in the current pregnancy or in multi-fetal pregnancies; Provide guidance for cervical cerclage placement; Confirm suspected anatomical uterine abnormality, including fibroid uterus; Localization of intrauterine device (IUD); Evaluate a pelvic mass that has been detected clinically. Updated Description, Coding, Discussion and References sections. 2013; 48(6):351-358. J Endourol. 2021; 127(5):544-552. 2004; 58(4):382-390. The focus of this study was the use of prostate specific antigen (PSA) as a predictor of disease-free survival after HIFU, not the outcomes related to HIFU treatment. Kanthabalan A, Peters M, Van Vulpen M, et al. Minerva Urol Nefrol. Available at. Ultrasound imaging can be used after delivery to evaluate abnormalities of the reproductive and adjacent structures. Schatzl G, Madersbacher S, Djavan B, et al. Medicare Supplement Plan F is great because it provides the most coverage of the 10 currently available MedSup plans. 2011; 185(4):1246-1254. Jawad MU, Scully SP. A statistically significant pain response was reported in 70.7% of this group. 2017; 71(2):267-273. Pain palliation for localized metastatic bone pain Bone pain is a common complaint for individuals with metastatic cancer to the bone. In the first phase III study published, Hurwitz and colleagues (2014) conducted a randomized, placebo-controlled, single-blind, multicenter, pivotal trial which included 147 participants with bone metastases from breast, prostate, kidney, lung or other primary tumors. Bonekamp D, Wolf MB, Roethke MC, et al. ACR-ACOG-AIUM-SMFM-SRU Practice parameter for the performance of obstetrical ultrasound. Focal salvage therapy for localized prostate cancer recurrence after external beam radiotherapy: a pilot study. Approximately 98% of subjects received 1 (60%) or 2 treatments (38%). A multicentre study of 5-year outcomes following focal therapy in treating clinically significant nonmetastatic prostate cancer. J Urol. BJU Int. Revised September 16, 2022. Zika virus was first reported in South America in May 2015 and since that time has now appeared in the United States. It is completely automated and therefore extremely rigid. This document addresses ultrasound ablative therapy for the treatment of oncologic conditions. NOTE: Information about the cost of this plan (called the . Ultrasound is currently being used as a therapeutic treatment, for example, lithotripsy to disintegrate kidney stones. In a prospective, non-randomized single arm trial, MRgFUS was used on 5 individuals with painful bone metastatic lesions with a pain rating of 4 or higher. 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. You bet! Providers are responsible for billing the appropriate CPT code, modifier, and diagnosis combinations. 2012; 105(2):198-202. Uchida T, Baba S, Irie A, et al. 1999a; 54(2):273-277. Coverage varies some from plan to plan, so check your plan's specifics. Addition of cell-free fetal deoxyribonucleic acid (DNA) screening for aneuploidy to Medically Necessary Statement. Single high intensity focused ultrasound session as a whole gland primary treatment for clinically localized prostate cancer: 10-year outcomes. 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. At 2 weeks follow-up, all individuals experienced a decrease in VAS pain scores from baseline (1.5-5). Safety trial of high-intensity focused ultrasound therapy for pancreatic cancer.