2014; 11(6):303. HIFU is a non-invasive ablative procedure which has the advantage of sparing surrounding tissue which may reduce postoperative morbidity and hasten recovery. Visit our official site today for more details. 2019; 29(1):299-308. Errico A. Rooms for rent in Bury flat and house shares - 3 currently available. However, the change from baseline in MEDD intake was not statistically significant, although the authors noted a trend towards a statistically significant change. Br J Surg. Grade 3 (n=1) and grade 2 (n=3) AEs related to urinary retention and urinary tract infection were reported. When services are Not Medically Necessary:For the procedure and diagnosis codes listed above when criteria are not met. Ideally the ultrasound is done at the same appointment as the screening mammogram. Five years experience of transrectal high-intensity focused ultrasound using the Sonablate device in the treatment of localized prostate cancer. The anthem blue cross rehab coverage is depending on the location of the policyholder and the specifics of their plan. Revised 2020. Due to variances in utilization patterns, each plan may choose whether to adopt a particular Clinical UM Guideline. Insurance coverage for whole-breast ultrasound is evolving. Yutkin V, Ahmed HU, Donaldson I, et al. 2005; 12(2):2593-2597. Updated References and Websites for additional information sections. A total of 23 studies comprised of 1157 individuals were included. Available at: American Cancer Society. Dupr A, Melodelima D, Prol D, et al. The prospective, nonrandomized, investigator-initiated, single-arm, single-center phase 1 study included 11 individuals with localized, histopathologically verified, radio-recurrent prostate cancer. 2015; 2015(7):CD007058. Re: Salvage high-intensity focused ultrasound for patients with recurrent prostate cancer after brachytherapy. Eur Urol Open Sci. Updated Description, Discussion, References and Websites for Additional Information sections. This guideline was reviewed and validated in 2011. Salvage high-intensity focused ultrasound (HIFU) for locally recurrent prostate cancer after failed radiation therapy: Multi-institutional analysis of 418 patients. 2015; 56(2):503-509. MPTAC review. J Endourol. Updated Coding section with additional diagnosis codes D25.0-D25.9, O26.872-O26.879, O99.210-O99.213, O99.810. The updated file enables providers to separately bill for the professional component (26) and the technical component (TC). 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. J Ultrasound Med 2013; 32(6):1083-1101. Chen L, Wang K, Chen Z, et al. 2012; 105(2):198-202. High-intensity focused ultrasound and localized prostate cancer: efficacy results from the European multicentric study. Blana A, Walter B, Rogenhofer S, Wieland WF. Prostate cancer therapy with high-intensity focused ultrasound. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020 Sep. Report No. Temperatures within the targeted area increase to 60-95C, which destroys the targeted tissue without damaging the adjacent tissue. 2010; 468(10):2825-2827. Safety trial of high-intensity focused ultrasound therapy for pancreatic cancer. Bone metastasis: When cancer cells have broken off from the primary tumor and have settled and started growing on bones. BJU Int. Low-Intensity Pulsed Ultrasound for Fracture Nonunion. Comparing high-intensity focal ultrasound hemiablation to robotic radical prostatectomy in the management of unilateral prostate cancer: a matched-pair analysis. Pak J Pharm Sci. . Anthem has begun denying coverage for . AIUM Practice Parameter for the Performance of Detailed Diagnostic Obstetric Ultrasound Examinations Between 12Weeks 0Days and 13Weeks 6Days. Salvage high-intensity focused ultrasound for patients with recurrent prostate cancer after brachytherapy. 2018; 30(4):233-242. 2008; 53(6):1194-1201. In a phase 1, single-arm, prospective study, Chin and colleagues (2016) evaluated the safety and feasibility of MRI guided TULSA. HAIFA, Israel- MIAMI, Dec. 22, 2022/CNW/ -- Insightec, a global healthcare company dedicated to using acoustic energy to transform patient care, announced today that Anthem is the third national. Minerva Urol Nefrol. Added Websites for Additional Information section. Urology. J Natl Cancer Inst. Prostate Cancer. In addition, eligible participants reported a numerical rating scale (NRS) pain score of 4 or greater in spite of maximal pain medication therapy, and a score of 7 or less on the Mirels fracture risk scale. Following treatment, no residual tumor was found in 46.2% of cases. Treatment of localized prostate cancer using high-intensity focused ultrasound. July 23, 2021. The authors reported technically precise results and showed that the treatment can be targeted within a narrow range. HAIFA, Israel - MIAMI, Florida (December 22, 2022) Insightec , a global healthcare company dedicated to using acoustic energy to transform patient care, announced today that Anthem is the third national payor to cover MR-guided Focused Ultrasound for treating medication-refractory Essential Tremor. Beerlage HP, van Leenders GJ, Oosterhof GO, et al. 2006a; 13(3):228-233. Inclusion or exclusion of a procedure, diagnosis or device code(s) does not constitute or imply member coverage or provider reimbursement policy. Zip Code or City, State . Transrectal high-intensity focused ultrasound in the treatment of localized prostate cancer: a multicenter study. 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. As the bone cortex absorbs high ultrasound energy, periosteal denervation may ensue, resulting in pain relief. 2016; 47(4):530-532. ; AUA Prostate Cancer Clinical Guideline Update Panel. 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. Ultrasound Obstet Gynecol. Participants received either MRgFUS (n=112) or placebo (n=35) treatment. June 7, 2018. The 2021 American Urological Association (AUA) published a guideline on renal mases and localized renal cancer. To determine if review is required for this Clinical UM Guideline, please contact the customer service number on the member's card. 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 . This early study focused on safety and technical feasibility rather than clinical outcomes. 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. Control of prostate cancer by transrectal HIFU in 227 patients. Shah TT, Peters M, Kanthabalan A, et al. TULSA is delivered by a system which includes real-time MR thermometry as well as robotically-driven directional thermal ultrasound in a closed loop system to ablate whole gland or targeted areas of the prostate. 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. Clin Genitourin Cancer. For other common visits, this is what you'll pay with PPO. Ahhhhh! Available at: Centers for Disease Control and Prevention (CDC). CT, digital radiography, ultrasound, mammography and DEXA equipment at each of our outpatient centers. Committee Opinion 723. Magnetic resonance imaging-guided transurethral ultrasound ablation in patients with localised prostate cancer: 3-year outcomes of a prospective Phase I study. The NCCN Prostate Cancer CPG (V1.2023) includes a recommendation for individuals with tumor recurrence following radiation therapy to include HIFU as a treatment option (2B recommendation). Pathological, oncologic and functional outcomes of a prospective registry of salvage high intensity focused ultrasound ablation for radiorecurrent prostate cancer. 1999b; 39(1):41-46. A set of individuals who were positive for insignificant disease at 12 months (n=4) or clinically significant disease at 12 months (n=5) required salvage treatment. Surgery: MRgFUS-non invasive treatment for patients with painful bone metastasis. Muto S, Yoshii T, Saito K, et al. Focal therapy for localised unifocal and multifocal prostate cancer: a prospective development study. Crouzet S, Blana A, Murat FJ, et al. Ahmed HU, Freeman A, Kirkham A, et al. Uchida T, Sanghvi NT, Gardner TA, et al. Urology. Subtle second-trimester ultrasound markers should be interpreted in the context of a background risk based on the patients age, history, genetic screening, and serum screening results. 2002; 59(3):394-398. Zacharakis E, Ahmed HU, Ishaq A, et al. Matthew Thornton Health Plan, Inc./Anthem Blue Cross and Blue Shield Coverage for: Individual + Family | Plan Type: HMO Anthem Silver Pathway X Enhanced HMO 5500/20% S05 ($0 Preferred Virtual Care + $0 Select Drugs) The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. High-intensity focused ultrasound for the treatment of localized prostate cancer: 5-year experience. Replaced term women with individual within clinical indications. Government Agency, Medical Society, and Other Authoritative Publications: Maternal UltrasoundObstetricPrenatalSonography. Rejection notice to me (if I'm lucky) and I start over. 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. Urology. Assessment of fetal well being, in the absence of the signs, symptoms, or conditions listed above; Providing a keepsake picture of the baby for the parents. MPTAC review. There were 12 grade 3 adverse events (AEs) attributable to the TULSA-PRO, all of which were resolved by 12 months. Routine Tests During Pregnancy. MR-guided focused ultrasound (MRgFUS) ablation for the treatment of nonspinal osteoid osteoma: a prospective multicenter evaluation. TULSA was developed as an alternative method of prostate tissue ablation. Updated June 13, 2019. It is not intended to be a recommendation of one product over another, and is not intended to represent a complete listing of all products available. Approximately 98% of subjects received 1 (60%) or 2 treatments (38%). Colombel M, Gelet A. 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). Effectiveness of 12-13-week scan for early diagnosis of fetal congenital anomalies in the cell-free DNA era. Prostate Cancer Prostatic Dis. Systematic review of innovative ablative therapies for the treatment of locally advanced pancreatic cancer. The document header wording updated from Current Effective Date to Publish Date. Updated Discussion/General Information, References and Websites for Additional Information sections. 2021; 127(5):544-552. 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 . 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. 2009; 16(1):140-146. ACR Appropriateness Criteria. 2017; 197(1):97-102. 2014; 7(4):270-281. HIFU or MRgFUS has also been studied as a potential treatment of various cancers. Pickles T, Goldenberg L, Steinhoff G. Technology review: high-intensity focused ultrasound for prostate cancer. Curr Urol Rep. 2003; 4(3):248-252. MPTAC review. Updated Coding section to add ICD-10-CM diagnosis codes O09.00-O09.03, O09.811-O09.829. The use of TULSA has been evaluated in several prospective and retrospective studies, with participants being treated for whole gland or partial gland ablation and as primary or salvage treatment as well as combined therapy for individuals with prostate cancer (Elterman, 2021; Lumiani, 2021; Ramsay, 2017). Cochrane Database Syst Rev. * From Jawad MU, Scully SP. The value of adding a universal booking scan to an existing protocol of routine mid-gestation ultrasound scan. In the obese patient, expectations regarding visualization of fetal anatomy should be tempered. Recommendations for the management of a pregnant individuals with suspected Zika virus infection include: The 2021 CDC guideline on the treatment of sexually transmitted infections includes management recommendations for individuals who are diagnosed with text in the second half of pregnancy. Gelet A, Chapelon JY, Bouvier R, et al. This study was defined by the regulatory agency to evaluate the effectiveness of the device to ablate prostate tissue. Influence of high intensity focused ultrasound (HIFU) treatment to the pancreatic function in pancreatic cancer patients. 2017; 119(6):896-904. The PSA level, which had dropped following treatment, remained low. Limani K, Aoun F, Holz S, et al. Available at. Ultrasound examinations can be used to assess fetal anatomy, particularly neuroanatomy, and to monitor growth. In brief: classifications in brief: Mirels' classification: metastatic disease in long bones and impending pathologic fracture. 2014; 106(5). Hinyokika Kiyo. 2015; 194(1):114. Gardner TA, Koch MO. The difference in response rates between MRgFUS and placebo at 3 months was significant (64.3% versus 20.0%). November 17, 2019. 2018; 74(4):422-429. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Evaluate for threatened, incomplete, or missed abortion; Non-reassuring fetal heart rate monitoring; Assess amniotic fluid volume in post-term gestation. You bet! Available at: U.S. National Library of Medicine. Available at: Second and Third Trimester Vaginal Bleeding. U.S. Food and Drug Administration (FDA). Summary of coverage and benefits PDF Service coverage and costs All employee health insurance plans provide one annual preventive care visit with your primary care provider at $0 co-pay within specified networks. 2018; 51(4):463-469. Crouzet S, Chapelon JY, Rouvire O, et al. An mpMRI, a transrectal ultrasound guided biopsy and a cystoscopy were performed at 12 months post-procedure. 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 . 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. Hemi salvage high-intensity focused ultrasound (HIFU) in unilateral radiorecurrent prostate cancer: a prospective two-centre study. 2020; 22:79-87. 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. Available at: High Intensity Ultrasound System for Prostate Tissue Ablation (TULSA-PRO System). Researchers used the visual analog pain score (VAS) to measure pain levels. Statement on Biological Effects of Ultrasound in Vivo. 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. 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. Jpn J Clin Oncol. Cochrane Database Syst Rev. NCD #220.5. 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. The PSA decreased from a median of 6.26 to 0.53 at 12 months. Updated Discussion, References and Websites for Additional Information sections. At 3 months, 72.2% (13/18) reported no pain without the use of pain medication, and 16.7% (3/18) reported a drop of at least 2 points on pain scale without an increase in pain medication. 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. At 2 weeks follow-up, all individuals experienced a decrease in VAS pain scores from baseline (1.5-5). Available at: Testing for Zika Virus Infections. Eur Urol. There were no new reported serious AEs. Revised May 20, 2020. Boccon-Gibod L, Djavan WB, Hammerer P, et al. November 6, 2015. Ultrasound examinations can be used to assess fetal anatomy, particularly neuroanatomy, and to monitor growth. Uddin Ahmed H, Cathcart P, Chalasani V, et al. 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. 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. Pain palliation for localized metastatic bone pain Bone pain is a common complaint for individuals with metastatic cancer to the bone. Therapies for clinically localized prostate cancer [Internet]. Medical Policy & Technology Assessment Committee (MPTAC) review. Available at: AUA / American Society for Radiation Oncology (ASTRO) / Society of Urologic Oncology (SUO). Updated Discussion/General Information, Coding and Reference sections. In Ohio: Community Insurance Company. There's Still Time To Enroll $0 preventive care. 2015; 102(3):182-193. Updated Coding section with 10/01/2018 ICD-10-CM diagnosis code changes; added Q51.20-Q51.28, Z20.821. In an intent-to-treat analysis, 63% (72/115) were reported to have a complete histological response and had no evidence of cancer. Technology insight: High-intensity focused ultrasound for urologic cancers. 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. List Your Practice ; Search . Transrectal high-intensity focused ultrasound: minimally invasive therapy of localized prostate cancer. J Urol. HIFU treatment is combined with a visualization method, frequently MR guidance, to better guide treatment in real time. PLoS One. High intensity focused ultrasound as first line salvage therapy in prostate cancer local relapse after radical prostatectomy: 4-year follow-up outcomes. Prostate Cancer (V1.2023). Liberman B, Gianfelice D, Inbar Y, et al. 2015; 28(3 Suppl):1097-1100. 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). After excluding the drop-out groups the results remained similarly statistically significant. Thompson I, Thrasher JB, Aus G, et al. Pain severity was measured using a 10-point pain scale questionnaire. 2004; 58(4):382-390. In the case of monochorionic twins, one scan per two weeks in the third trimester is considered medically necessary; For twin-twin transfusion syndrome, one scan per week and serial exams, more than once per week, beginning once the diagnosis of monochorionic twins or twin-twin transfusion is made; Confirm suspected abnormal fetal position or presentation; As an adjunct to external version from breech to vertex presentation; A known or suspected exposure to Zika virus. Ahmed HU, Hindley RG, Dickinson L, et al. Localized metastatic bone pain is a non-invasive ablative procedure which has the advantage sparing. Treatment to the bone cortex absorbs high ultrasound energy, periosteal denervation may ensue, resulting pain! Not Medically Necessary: for the treatment of localized prostate anthem ultrasound coverage local relapse after prostatectomy... 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