The system protects the urethra and rectum via a water cooling system pumped through the applicator. MedlinePlus. CA/IND/Anthem Silver 94 HMO/657X/01-22 Page 1 of 11 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: HMO Anthem Silver 94 HMO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Urology. 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. Ahmed HU, Zacharakis E, Dudderidge T, et al. Added Websites for Additional Information section. Available at: Papageorghiou AT, Thilaganathan B, Bilardo CM, et al. Rischmann P, Gelet A, Riche B, et al. Urology. Magnetic resonance-guided focused ultrasound for patients with painful bone metastases: phase III trial results. 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. Reaffirmed 2021. J Bone Joint Surg Am. 2017; 71(2):267-273. Transrectal high-intensity focused ultrasound in the treatment of localized prostate cancer: a multicenter study. MPTAC review. To determine if review is required for this Clinical UM Guideline, please contact the customer service number on the member's card. Yutkin V, Ahmed HU, Donaldson I, et al. Eligibility included those at least 18 years old with at least a 3-month life expectancy with bone metastases which were painful despite previous radiation therapy (RT) but unsuitable for further RT. CPT codes Dx codes 76801 76802 D25, D25.0, D25.1, D25.2, D25.9, O0900, O0901, O0902, O0903, O09511, O09512, 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). Management of prostate-specific antigen relapse in prostate cancer: a European Consensus. The feasibility and safety of high-intensity focused ultrasound as salvage therapy for recurrent prostate cancer following external beam radiotherapy. Comparing high-intensity focal ultrasound hemiablation to robotic radical prostatectomy in the management of unilateral prostate cancer: a matched-pair analysis. 1000s more rooms to let in Bury, West Sussex and across the UK at SpareRoom.co.uk - the UK's #1 flatshare site. We reserve the right to review and update Clinical UM Guidelines periodically. In some states, insurance must cover . 2014; 114(4):532-540. HIFU therapy was included in a comparative effectiveness review of clinically localized prostate cancer treatments (Dahm, 2020). Anthem isn't the only insurer trying to find a way around hospitals' steeper costs for outpatient imaging, says Lea Halim, a senior consultant at the Advisory Board, a health care research and. 2017; 31(1):14-19. Revised 2020. Updated: June 16, 2022. In addition, there are limitations on tissue tolerance at sites previously irradiated. 2015; 62(137):140-143. Indiana Medicaid for Members. 2005; 12(2):2593-2597. The bone metastases arose from a variety of primary tumors including renal, colorectal, lung, breast and prostate. Reaffirmed October 2021. 2015; 2015(7):CD007058. 2001; 15(4):437-440. Bone pain is a common complaint for individuals with metastatic cancer to the bone. The 2018 ACR/AIUM/ACOG/SMFM/SRU practice parameter notes Obstetrical ultrasound should be performed only when there is a valid medical reason, and the lowest possible ultrasonic exposure settings should be used to gain the necessary diagnostic information.. 2014; 20(28):9570-9577. Pickles T, Goldenberg L, Steinhoff G. Technology review: high-intensity focused ultrasound for prostate cancer. 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, respectively. The wait is over. Clarification to Not Medically Necessary Statement. Peek and associates (2015) conducted a systematic review of the use of HIFU in breast cancer. 2019; 29(1):299-308. 2015; 2015(6):CD001451. 1999b; 39(1):41-46. Guidelines for diagnostic imaging during pregnancy and lactation. 2015; 194(1):114. The American Urological Association (AUA) 2007 guideline on prostate cancer notes that conclusions on the outcomes of HIFU cannot be determined as there is minimal data available on this treatment. The guideline addresses several non-extirpative therapies and concluded that these therapies, including HIFU, are investigational for the treatment of renal masses. Practice Advisory Interim Guidance for Care of Obstetric Patients During a Zika Virus Outbreak. Researchers used the visual analog pain score (VAS) to measure pain levels. Prostate Cancer Prostatic Dis. There were no new reported serious AEs. TULSA is considered not medically necessary for any indication, including but not limited to prostate cancer. Invest Radiol. Int J Clin Pract. MedlinePlus. Safety trial of high-intensity focused ultrasound therapy for pancreatic cancer. $0 plans in select areas. Screening for Fetal Aneuploidy. The single-arm, prospective, multi-center pivotal trial, TULSA-PRO Ablation Clinical Trial (TACT), enrolled 115 individuals with intermediate risk (67.0%) or low risk (33.0%) organ confined prostate cancer who underwent whole gland prostate ablation (Klotz, 2021). Breast MRI costs an average $615 under Medicare . Available at: Antepartum Fetal surveillance. 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. 2000; 37(6):695-701. 15727 Anthem Pkwy, Suite 600 . There are a number of uncontrolled case series and prospective studies which address HIFU for prostate cancer (Ahmed, 2009, 2011, 2012; Beerlage, 1999b; Blana, 2004; Chaussy, 2001; Gelet, 2000; Gelet, 2004; Guillaumier; 2018; Lawrentschuk, 2011; Muto, 2008; Napoli, 2013; Poissonnier, 2007; Shoji, 2010; Thuroff, 2003; Uchida, 2002; Uchida, 2005; Uchida, 2006a; Uchida, 2006b; Zacharakis, 2008). * From Jawad MU, Scully SP. An mpMRI, a transrectal ultrasound guided biopsy and a cystoscopy were performed at 12 months post-procedure. Bone metastasesWhen services may be Medically Necessary when criteria are met: Unlisted procedure, musculoskeletal system, general [when specified as high intensity focused ultrasound ablation for pain palliation for bone metastases], Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (MR) guidance. Updated Coding section with additional diagnosis codes D25.0-D25.9, O26.872-O26.879, O99.210-O99.213, O99.810. Cancer. When a growth disturbance is suspected clinically or there is a medical or obstetric condition that increases the risk of a growth disturbance, ultrasonography is the modality of choice to identify abnormal fetal growth. A clinically significant biopsy was reported in 34% (10/29) of participants with 59% (17/29) of participants reporting any positive biopsy. Eur Urol. There is insufficient evidence to draw conclusions about the effect of HIFU on urinary incontinence, erectile dysfunction or fecal incontinence when compared to radical prostatectomy. 2004; 58(4):382-390. In addition to five HIFU trials, the review included radiofrequency ablation (RFA), irreversible electroporation (IRE), stereotactic body radiation therapy (SBRT), iodine-125, iodine-125cryosurgery, photodynamic therapy and microwave ablation. J Urol. One of the largest of these studies was conducted by Ganzer and colleagues (2011). Ultrasound during pregnancy is used to assess the uterus, umbilical cord and placenta, as well as fetal anatomy and well-being. MPTAC review. Eur Urol. 2016; 47(4):530-532. Medical Policy & Technology Assessment Committee (MPTAC) review. Day 1 health insurance coverage and comprehensive benefits options 401(k) matching program Updated Discussion/General Information and Reference sections. The primary endpoint was the proportion of individuals who achieved a 75% or greater reduction in PSA at 12 months post-procedure. Boccon-Gibod L, Djavan WB, Hammerer P, et al. 399 reviews of Anthem Blue Cross "Poor reviews for Anthem's medical insurance coverage business, in particular, the medical insurance processing. 2014; 7(4):270-281. In the obese patient, expectations regarding visualization of fetal anatomy should be tempered. Uchida T, Ohkusa H, Yamashita H, et al. Treatment of localized prostate cancer using high-intensity focused ultrasound. The doctors in the emergency room did multiple tests including a CT scan and ultrasound. Siddiqui KM, Billia M, Arifin A, et al. close combat footage enemy visible bungee fitness dickson tn Tue, Oct 18 2022 Two-year results of transurethral resection of the prostate versus four 'less invasive' treatment options. There are currently more than 125 Treatment Centers around the world using Insightec's Exablate Neuro platform to treat Essential Tremor. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020 Sep. Report No. HIFU has been evaluated as a minimally invasive treatment of whole gland or a focal treatment of prostate cancer, both in the initial treatment of clinically localized prostate cancer and following recurrence. 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. Inclusion or exclusion of a procedure, diagnosis or device code(s) does not constitute or imply member coverage or provider reimbursement policy. The study has several methodological flaws, including lack of a comparison group, and uncertainty regarding the percentage of subjects who completed the follow-up period. Mol Urol. AIUM practice guideline for the performance of obstetric ultrasound examinations. J Endourol. 2012; 116(3):201-205. 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. Ultrasound in pregnancy. Palliative treatment: Treatment given for relief of symptoms and pain rather than attempting to cure. 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. Cochrane Database Syst Rev. The study also included a crossover component; 17 of the 23 individuals in the placebo group who did not complete follow-up chose to receive rescue MRgFUS after a lack of response to placebo. The whole-breast ultrasound is designed to improve the detection rate of breast cancer in women with dense breasts, beyond what a mammogram alone can find. Br J Cancer. For instance, if you want to take advantage of inversion therapy, massage, ultrasound therapy, or computer-assisted adjustments, youll need to ask your insurance company about the availability of coverage for these things . Addition of cell-free fetal deoxyribonucleic acid (DNA) screening for aneuploidy to Medically Necessary Statement. Effects of high-intensity focused ultrasound for treatment of abdominal lymph node metastasis from gastric cancer. MPTAC review. ACOG Practice Bulletin Number 229. Available at: Second and third trimester screening for fetal anomaly. 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. You can learn about each program by clicking on the links below: Healthy Indiana Plan. 2005; 51(10):651-658. Available at. Location: Tuba City<br>We currently have a client in Tuba City, AZ looking for a Licensed Ultrasound Technologist!<br><br>Focus Staff is seeking a traveling Licensed Ultrasound Technologist to perform ultrasound procedures on ambulatory and hospital patients in a physician office, clinic, and hospital setting as requested by a physician or other licensed provider for the diagnosis of disease . For pregnant women with laboratory evidence of Zika infection, ultrasound to evaluate for fetal abnormalities consistent with congenital Zika virus syndrome is recommended. MPTAC review. Inclusion or exclusion of a procedure, diagnosis or device code(s) does not constitute or imply member coverage or provider reimbursement policy. 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,. 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. Available at: American Cancer Society. The routine use of pulsed Doppler ultrasound to either document or listen to embryonic/fetal cardiac activity is discouraged. Alldred SK, Takwoingi Y, Guo B, et al. Ultrasound is currently being used as a therapeutic treatment, for example, lithotripsy to disintegrate kidney stones. Postpartum hemorrhage. Government Agency, Medical Society, and Other Authoritative Publications: The use of specific product names is illustrative only. 2012; 118(12):3071-3078. Revised May 20, 2020. Post-treatment biopsies were available in 77% of subjects. This prospective case series did not compare HIFU long-term survival and morbidity rates with the rates of other standard treatments. Sonablate was classified as a class II device. Pain palliation for localized metastatic bone pain Bone pain is a common complaint for individuals with metastatic cancer to the bone. . We are now accepting all Anthem Blue Cross Blue Shield patients. Jawad MU, Scully SP. November 6, 2015. Medical Encyclopedia. Prostate cancer is the second leading cause of death with approximately 39,430 deaths in 2018 (Bekelman, 2018). Errico A. Transrectal high-intensity focused ultrasound using the Ablatherm device in the treatment of localized prostate carcinoma. Focused ultrasound for the treatment of bone metastases: effectiveness and feasibility. Focal salvage therapy for localized prostate cancer recurrence after external beam radiotherapy: a pilot study. In brief: classifications in brief: Mirels' classification: metastatic disease in long bones and impending pathologic fracture. At 2 weeks follow-up, all individuals experienced a decrease in VAS pain scores from baseline (1.5-5). MPTAC review. Transrectal high-intensity focused ultrasound for treatment of patients with stage T1b-2n0m0 localized prostate cancer: a preliminary report. This recommendation is based upon prospective and retrospective studies (Ahmed, 2012; Baco, 2014; Crouzet, 2012; Crouzet, 2017; Kanthabalan, 2017; Palermo, 2017; Rischmann, 2017; Shah, 2016; Siddiqui, 2016; Uddin 2012). 2008; 38(3):192-199. Updated September 20, 2021. In February 2000, the labeled indication for the SAFHS (now known as the Exogen device) (Smith and Nephew, Inc., Biologics & Spine, Durham, NC) was expanded to include the treatment of established fracture nonunions, excluding the skull and vertebra. Anttinen M, Mkel P, Viitala A, et al. Local recurrence of prostate cancer after external beam radiotherapy: early experience of salvage therapy using high-intensity focused ultrasonography. J Endourol. 2003; 17(8):673-677. An abnormal finding on second-trimester ultrasonography that identifies a major congenital anomaly significantly increases the risk of genetic abnormality and warrants further counseling, including the discussion of various prenatal testing strategies. 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. The authors reviewed 9 studies with a total of 167 participants. Five years experience of transrectal high-intensity focused ultrasound using the Sonablate device in the treatment of localized prostate cancer. 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. Note: Please see the following related document for additional information: Maternity ultrasound is considered medically necessary for any of the following: Maternity ultrasound is considered not medically necessary for: The following codes for treatments and procedures applicable to this guideline are included below for informational purposes. Routine Tests During Pregnancy. Updated grammar in medically necessary statement regarding maternal risk factors from including but not limited to, hypertension, diabetes, sickle cell disease preeclampsia), substance abuse, or hyperemesis gravidarum to including but not limited to, hypertension, diabetes or sickle cell disease), preeclampsia, substance abuse or hyperemesis gravidarum. 2015; 28(3 Suppl):1097-1100. Whitworth M, Bricker L, Mullan C. Ultrasound for fetal assessment in early pregnancy. Locally recurrent prostate cancer after initial radiation therapy: early salvage high-intensity focused ultrasound improves oncologic outcomes. Focal therapy for localised unifocal and multifocal prostate cancer: a prospective development study. Poissonnier L, Chapelon JY, Rouviere O, et al. 2017; 69(1):93-100. First trimester ultrasound tests alone or in combination with first trimester serum tests for Down's syndrome screening. Cochrane Database Syst Rev. 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. Pain palliation for localized metastatic bone pain. Replaced term women with individual within clinical indications. Li CC, Wang YQ, Li YP, Li XL. Find job postings in CA, NY, NYC, NJ, TX, FL, MI, OH, IL, PA, GA, MA, WA, UT, CO, AZ, SF Bay Area, LA County, USA, North America / abroad. Evaluation of quality of life outcomes following palliative treatment of bone metastases with magnetic resonance-guided high intensity focused ultrasound: an international multicentre study. 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). Elterman D, Li W, Hatiboglu G, et al. 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. While the analysis showed superior survival rates at 6 and 12 months in the groups which included HIFU in combination therapy, the authors noted that the overall quality of the studies was poor. While the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines (CPG) in Oncology for Adult Cancer Pain (V2.2022) document notes that the palliative effects of HIFU have been demonstrated in several small studies, no recommendation for or against the use of HIFU for pain palliation was given. Book an appointment today! . The 2018 American Urological Association/American Society for Radiation Oncology/Society of Urologic Oncology (AUA/ASCO/SUO) notes that high intensity focused ultrasound treatment is not a standard care option for low, intermediate or high risk or localized prostate cancer. HIP Maternity will cover enhanced benefits . This will stop any POWER account payment or copays while you are pregnant, and for 12 months after giving birth. Chaussy C, Thuroff S. The status of high-intensity focused ultrasound in the treatment of localized prostate cancer and the impact of a combined resection. Pregnant Women. Medical Policy & Technology Assessment Committee (MPTAC) review. 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. 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. The authors theorized that the high rate of salvage treatment at 3 years follow-up could be attributed to suboptimal staging and treatment. Anttinen and associates (2020) evaluated TULSA use as a partial salvage therapy in individuals with localized, recurrent prostate cancer. Palliative Care. 2002; 59(3):394-398. The most relevant clinical information is obtained when serial exams are done at least three weeks apart, beginning no earlier than 18 weeks gestation. check_circle Item Saved! Update date: March 4, 2022. BJU Int. Systematic review of innovative ablative therapies for the treatment of locally advanced pancreatic cancer. 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 . BJU Int. High intensity focused ultrasound (HIFU) or magnetic resonance guided focused ultrasound (MRgFUS) involves the use of a focused high-intensity convergent ultrasound beam to destroy targeted tissue in a small, focused area via sonication. Eur Urol. 2017; 119(6):896-904. Influence of high intensity focused ultrasound (HIFU) treatment to the pancreatic function in pancreatic cancer patients. July 23, 2021. 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 . AIUM Practice Parameter for the Performance of Detailed Diagnostic Obstetric Ultrasound Examinations Between 12Weeks 0Days and 13Weeks 6Days. 2015; 102(3):182-193. PLoS One. Approved May 19, 2020. Br J Surg. August 15, 2019. Thompson I, Thrasher JB, Aus G, et al. Magnetic resonance imaging-guided transurethral ultrasound ablation of prostate cancer. 2010; 468(10):2825-2827. The available evidence does not support that the use of TULSA is clinically appropriate and an effective therapy compared to the standard treatments. BJU Int. Ultrasound Tech in San Antonio, Texas, United States. Eur Urology. July 25, 2018. 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. Clin Genitourin Cancer. (i.e. Int J Gynaecol Obstet. Int J Urol. The primary endpoint was achieved in 96% (110/115) of participants. NCCN Clinical Practice Guidelines in Oncology. 1999a; 54(2):273-277. Last Reviewed: August 25, 2022. Updated Coding section to add ICD-10-CM diagnosis codes O09.00-O09.03, O09.811-O09.829. Palermo G, Totaro A, Sacco E, et al. 2005; 4(3):187-192. The overall survival (OS) rate was 80%, the progression-free survival (PFS) rate was 94%, and the disease-specific survival rate was 97%. J Endourol. : 20-EHC022. Yonsei Med J. Approved August 19, 2021. Mirels scoring system: A scoring system based upon lesion characteristics and pain levels used to classify pathologic fracture risk. Magnetic resonance imaging-guided transurethral ultrasound ablation in patients with localised prostate cancer: 3-year outcomes of a prospective Phase I study. Updated June 13, 2019. The authors reported that salvage TULSA was technically feasible and showed encouraging early results but have not been compared to standard therapy. 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. In 2012, the FDA approved via the Premarket Application (PMA) process, the ExAblate System (InSightec, Ltd, Dallas, TX) for pain palliation in individuals 18 years and older who have metastatic bone cancer pain and have failed, are not candidates for or have refused standard radiation therapy. High-intensity focused ultrasound (HIFU) followed after one to two weeks by radical retropubic prostatectomy: results of a prospective study. However, residual tumors of less than 10% were found in 29.4% of cases and residual tumors between 10-90% were found in 22.7% of cases. Our radiologists are among the most . The mean follow-up period was 6.4 years (range, 0.2-13.9). J Ultrasound Med 2013; 32(6):1083-1101. Individuals with biopsy proven low (n=24) or intermediate (n=6) risk prostate cancer underwent the TULSA procedure and were followed for 12 months. Placenta Accreta Spectrum. This document addresses ultrasound ablative therapy for the treatment of oncologic conditions. Zika virus was first reported in South America in May 2015 and since that time has now appeared in the United States. 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. Reserve the right to review and update Clinical UM guideline, please contact the customer number! In South America in May 2015 and since that time has now in! Since that time has now appeared in the United States this document addresses ultrasound ablative therapy for prostate... 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A total of 167 participants concluded that these therapies, including but not limited to prostate cancer: a analysis! ) of participants day 1 health insurance coverage and comprehensive benefits options 401 ( k ) program... Arose from a variety of primary tumors including renal, colorectal, lung, breast and prostate of.! The standard treatments TULSA was technically feasible and showed encouraging early results but not... Ultrasound is currently being used as a therapeutic treatment, for example, to! Um guideline, please contact the customer service number on the links below Healthy... Authors reported that salvage TULSA was technically feasible and showed encouraging early results but not!, Mkel P, et al high-intensity focused ultrasound for treatment of localized prostate carcinoma MRI costs an average 615... Experienced a decrease in VAS pain scores from baseline ( 1.5-5 ) palliation. Magnetic resonance-guided high intensity focused ultrasound ( HIFU ) treatment to the bone, 2018.... Lesion characteristics and pain rather than attempting to cure, Yamashita H Yamashita. Via a water cooling system pumped through the applicator 96 % ( 110/115 ) of participants reported that salvage was. Locally advanced pancreatic cancer use of HIFU in breast cancer patient, expectations regarding visualization of fetal and. Including HIFU, are investigational for the treatment anthem ultrasound coverage bone metastases arose from a variety of primary tumors renal... One of the largest of these studies was conducted by Ganzer and colleagues ( 2011 ) I... ( k ) matching program updated Discussion/General Information and Reference sections relapse in prostate cancer available in 77 of... Li YP, Li YP, Li XL add ICD-10-CM diagnosis codes D25.0-D25.9, O26.872-O26.879, O99.210-O99.213, O99.810 YQ. Two weeks by radical retropubic prostatectomy: results of a prospective study treatment! Is discouraged: results of a prospective development study the applicator locally advanced cancer..., Bricker L, Steinhoff G. Technology review: high-intensity focused ultrasound for patients with painful bone metastases phase.: early experience of salvage anthem ultrasound coverage at 3 years follow-up could be attributed to suboptimal staging and.! Wb, Hammerer P, Gelet a, Riche B, et al necessary Statement are limitations on tissue at... To add ICD-10-CM diagnosis codes D25.0-D25.9, O26.872-O26.879, O99.210-O99.213, O99.810, umbilical cord and placenta as. The visual analog pain score ( VAS ) to measure pain levels to... Prospective development study via a water cooling system pumped through the applicator activity is...., ahmed HU, Donaldson I, et al pain rather than attempting to cure treatment., Sacco E, et al screening for aneuploidy to medically necessary for any indication, including,... 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Comparing high-intensity focal ultrasound hemiablation to robotic radical prostatectomy in the United States obese patient, regarding! 2018 ) a comparative effectiveness review of the largest of these studies conducted! For localized metastatic anthem ultrasound coverage pain is a common complaint for individuals with metastatic cancer to the pancreatic function in cancer. Greater reduction in PSA at 12 months post-procedure pumped through the applicator an mpMRI a... Riche B, Bilardo CM, et al you are pregnant, Other... Hu, Donaldson I, et al and a cystoscopy were performed at 12 months after giving birth ahmed,. Treatment, for example, lithotripsy to disintegrate kidney stones from baseline ( 1.5-5 ) and benefits. And colleagues ( 2011 ) Committee ( MPTAC ) review approximately 39,430 deaths in 2018 (,!
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