anthem ultrasound coverage

Palermo G, Totaro A, Sacco E, et al. Thompson I, Thrasher JB, Aus G, et al. The authors concluded, Although newer modalities hold promise, we need higher quality studies to assess patient important outcomes to guide evidence-based clinical practice.. The guideline addresses several non-extirpative therapies and concluded that these therapies, including HIFU, are investigational for the treatment of renal masses. Liberman B, Gianfelice D, Inbar Y, et al. List Your Practice ; Search . While there is no reliable evidence to support ultrasounds performed during pregnancy will harm a fetus, there is general agreement that the casual use of ultrasonography during pregnancy should be avoided (ACOG, 2018). There are currently two ultrasound ablative techniques. Lancet Oncol. First clinical experience of intra-operative high intensity focused ultrasound in patients with colorectal liver metastases: a phase I-IIa study. Salvage high-intensity focused ultrasound (HIFU) for locally recurrent prostate cancer after failed radiation therapy: Multi-institutional analysis of 418 patients. Bone Metastases. ACOG Practice Bulletin 163. 2014; 20(28):9570-9577. BJU Int. Available at: American Institute of Ultrasound in Medicine (AIUM). The mean follow-up period was 6.4 years (range, 0.2-13.9). Crouzet S, Blana A, Murat FJ, et al. Available at: Second and Third Trimester Vaginal Bleeding. Ann Surg Oncol. Reviewed and validity confirmed 2011. NOTE: Information about the cost of this plan (called the . Indiana Medicaid provides coverage to pregnant women through two programs. 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. 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 remaining 11.1% (2/18) reported pain reoccurrence which required pharmacological care. Magnetic resonance-guided focused ultrasound for patients with painful bone metastases: phase III trial results. 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. Eur Urol Open Sci. ultrasound). Available at: Centers for Disease Control and Prevention (CDC). Bertrand AS, Iannessi A, Natale R, et al. Ultrasound abnormalities have been detected in the fetus from 2 to 29 weeks after symptom onset, and therefore, insufficient data are available to define the optimal timing between exposure and initial sonographic screening. Yutkin V, Ahmed HU, Donaldson I, et al. 2014; 106(5). J Ultrasound Med 2013; 32(6):1083-1101. HIFU or MRgFUS has also been studied as a potential treatment of various cancers. Updated Discussion, References and Websites for Additional Information sections. The bone metastases arose from a variety of primary tumors including renal, colorectal, lung, breast and prostate. MPTAC review. There were no new reported serious AEs. Updated Discussion/General Information, Coding and Reference sections. Sexually Transmitted Infections Treatment Guidelines, 2021. Updated Coding section with 10/01/2020 ICD-10-CM changes; added O99.891; removed Q51.20 deleted 09/30/2020. Prostate Cancer. CA/IND/Anthem Silver 73 HMO/657G/01-22 Page 1 of 12 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 73 HMO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. Twelve-month prostate volume reduction after MRI-guided transurethral ultrasound ablation of the prostate. Updated Coding, Description, Discussion/General Information, and References. 2013; 63(2):395-398. Assess vaginal bleeding of undetermined etiology; Assess abdominal or pelvic pain of undetermined etiology; Evaluation of fetal condition in late registrants for prenatal care; History of unexplained fetal demise in a previous pregnancy; Assess the fetus in cases with maternal risk factors such as family history of congenital abnormalities, chronic systemic disease (including but not limited to, hypertension, diabetes or sickle cell disease), preeclampsia, substance abuse or hyperemesis gravidarum; Assessment of fetus after abnormal serum Alpha Fetal Protein (AFP), serum screen or multiple analyte serum screen, or cell-free fetal deoxyribonucleic acid (DNA) screening for aneuploidy; Suspected ectopic pregnancy or hydatidiform mole, and to follow hydatidiform mole; Assess the fetus in cases of Rhesus (Rh) isoimmunization and other causes of fetal hydrops; Provide guidance for other testing, such as amniocentesis, chorionic villus sampling, and cordocentesis or procedures such as intrauterine blood transfusions or other in-utero fetal therapeutic procedures. Bone metastases are common in breast and prostate cancer (Liberman, 2009). Reformatted Coding section. Updated Discussion/General Information, References and Websites for Additional Information sections. 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). 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 . Systematic review of high-intensity focused ultrasound ablation in the treatment of breast cancer. : 20-EHC022. In brief: classifications in brief: Mirels' classification: metastatic disease in long bones and impending pathologic fracture. October 2016. The value of adding a universal booking scan to an existing protocol of routine mid-gestation ultrasound scan. . These adjustments apply to members of Commercial business, including self-insured plans, Medicare, and Medi-Cal business. At various gestational ages, ultrasound examination is an accurate method of determining gestational age, fetal number, viability, and placental location, and it is recommended for all pregnant patients. Updated: June 16, 2022. A multicentre study of 5-year outcomes following focal therapy in treating clinically significant nonmetastatic prostate cancer. 2000; 4(3):183-187. Eur Urol. 2015; 10(2):e0118212. 2013; 48(6):351-358. 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. 2014; 65(5):907-914. Eur Urology. Rischmann P, Gelet A, Riche B, et al. Uchida T, Ohkusa H, Yamashita H, et al. Updated Coding section with 10/01/2016 ICD-10-CM diagnosis code changes. Baco E, Gelet A, Crouzet S, et al. MedlinePlus. Ultrasound examinations can be used to assess fetal anatomy, particularly neuroanatomy, and to monitor growth. The majority of events were minor and reversible. 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. Visit our official site today for more details. In an intent-to-treat analysis, 63% (72/115) were reported to have a complete histological response and had no evidence of cancer. Low-Intensity Pulsed Ultrasound for Fracture Nonunion. Nair SM, Hatiboglu G, Relle J, et al. Ultrasound in pregnancy. The maternal cervix and adnexa should be examined. 2006a; 13(3):228-233. This study was defined by the regulatory agency to evaluate the effectiveness of the device to ablate prostate tissue. Chaussy C, Thuroff S, Rebillard X, Gelet A. 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). Liberman and associates (2009) used MRgFUS to treat 31 individuals with painful bone metastases who had exhausted or refused all other pain palliation methods. Anthem is the third national payer to agree to cover treatment Anthem incorporates MR-guided focused ultrasound for essential tremor into coverage Over 1600 Total Lots Up For Auction at One . Routine Tests During Pregnancy. 2004; 7(4):289-294. There are concerns about inconsistent treatment coverage within renal masses resulting in incomplete ablation. ACR-ACOG-AIUM-SMFM-SRU Practice parameter for the performance of obstetrical ultrasound. In addition to treatment, these individuals should undergo a sonographic fetal evaluation to evaluate for signs of fetal or placental syphilis. High intensity focused ultrasound (HIFU): A surgical procedure that uses focused high energy sound waves to destroy target tissues in the body. Medical Encyclopedia. This study was a retrospective case series involving 804 subjects who underwent HIFU and were included in an industry-sponsored registry. 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. There were no reported treatment related severe adverse events (AEs). Effectiveness of 12-13-week scan for early diagnosis of fetal congenital anomalies in the cell-free DNA era. 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). Pain palliation in patients with bone metastases using MR-guided focused ultrasound surgery: a multicenter study. High-intensity focused ultrasound for treatment of pancreatic cancer: a systematic review. Influence of high intensity focused ultrasound (HIFU) treatment to the pancreatic function in pancreatic cancer patients. Locally recurrent prostate cancer after initial radiation therapy: early salvage high-intensity focused ultrasound improves oncologic outcomes. Improved outcomes with advancements in high intensity focused ultrasound devices for the treatment of localized prostate cancer. 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. These Medical Policies serve as guidelines for health care benefit coverage decisions, which may vary according to the different products and benefit plans offered by BCBSIL. HIFU therapy was included in a comparative effectiveness review of clinically localized prostate cancer treatments (Dahm, 2020). However, the change from baseline in MEDD intake was not statistically significant, although the authors noted a trend towards a statistically significant change. Bone pain is a common complaint for individuals with metastatic cancer to the bone. 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. In 2021, Nair and colleagues reported the 3-year outcomes of the participants in the Chin study. Last Reviewed: August 25, 2022. In 2015, The U.S. Food and Drug Administration (FDA) approved two devices for use in prostate cancer. 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. Rooms for rent in Bury flat and house shares - 3 currently available. 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. Updated Coding section; corrected ICD-10 diagnosis code O41.00X0. HIFU was comparable to the median survival in standard chemotherapy. 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. PLoS One. August 15, 2019. When an embryo/fetus is detected, it should be measured, and the cardiac activity should be recorded by 2-D video clip or M-mode. Individuals received either whole gland (n=8) or partial (n=8) ablation. J Bone Joint Surg Am. 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. BJU Int. Rejection notice to me (if I'm lucky) and I start over. The PSA decreased from a median of 6.26 to 0.53 at 12 months. Guillaumier S, Peters M, Arya M, et al. Centers for Disease Control and Prevention (CDC). When high-intensity ultrasound waves are used in place of low-intensity, body tissue absorbs, rather than reflects the energy. 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. 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. 2014; 2014:186782. 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. 2019; 29(1):299-308. Obstetric Care Consensus. MPTAC review. Transrectal high-intensity focused ultrasound in the treatment of localized prostate cancer. Ultrasound averages range from $54 to $100. Crouzet S, Chapelon JY, Rouvire O, et al. Summary of Safety and Effectiveness Data (SSED). The following codes for treatments and procedures applicable to this guideline are included below for informational purposes. 2015; 102(3):182-193. -12/31/2022 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family | Plan Type: HMO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan.The SBC shows you how you and the plan would share the cost for covered health care services. August 27, 2020. High-intensity focused ultrasound (HIFU) followed after one to two weeks by radical retropubic prostatectomy: results of a prospective study. In some states, insurance must cover . J Urol. The feasibility and safety of high-intensity focused ultrasound as salvage therapy for recurrent prostate cancer following external beam radiotherapy. 2011; 108(8 Pt 2):E196-E201. Klotz L, Pavlovich CP, Chin J, et al. (2018). Clin Oncol (R Coll Radiol). 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 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. The price of a diagnostic mammogram averages from $172 under Medicare to $239 with private insurance. Kenkhuis MJA, Bakker M, Bardi F, ET AL. In a statement, Anthem says, "Anthem health plans cover 222 contraceptive products at $0 cost share on our ACA Preventive List." The company went on to say that it covers "at least one product" in . The resulting heat and cavitation destroys the targeted tissue. It is likely that both of these treatment effects contribute to pain relief. Committee Opinion 723. Eur Urol. Clin Genitourin Cancer. The difference in response rates between MRgFUS and placebo at 3 months was significant (64.3% versus 20.0%). Adverse events included grade 1 or 2 hematuria, urinary tract infections or acute urinary retention, and grade 3 epididymitis. By March 2018, Anthem (Blue Cross/Blue Shield) will require that MR and CT scans considered "not medically necessary" be performed at freestanding medical imaging facilities in order to be covered. We are now accepting all Anthem Blue Cross Blue Shield patients. Available at: Second and third trimester screening for fetal anomaly. MPTAC review. MPTAC review. 2005; 19(6):693-701. 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. The most commonly reported complications included Stress 1 urinary incontinence (18.7%), followed by obstruction of the bladder outlet (16.6%), and acute urinary retention (7.6%). One ultrasound of a pregnant uterus per member, per routine course of care; Estimate gestational age for individuals with uncertain clinical dates. Removed ICD-9 codes from Coding section. AIUM Practice Parameter for the Performance of Detailed Diagnostic Obstetric Ultrasound Examinations Between 12Weeks 0Days and 13Weeks 6Days. You can learn about each program by clicking on the links below: Healthy Indiana Plan. The benefits and limitations of ultrasonography should be discussed with all patients. Therapies for clinically localized prostate cancer [Internet]. J Endourol. 2015; 2015(6):CD001451. Napoli A, Anzidei M, De Nunzio C, et al. J Urol. Focal therapy for localized prostate cancer: a phase I/II trial. Anthem last week said it has updated its coverage policies for ED visits, following criticism of the insurer's policy to deny coverage of ED visits for minor conditions that could "safely [be] treated in less acute facilities." Learn more: Get the primers for reducing avoidable ED utilization Background Ganzer R, Robertson CN, Ward JF, 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. 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. 2016; 19(3):311-316. Due to variances in utilization patterns, each plan may choose whether to adopt a particular Clinical UM Guideline. Accessed on October 20, 2022. Siddiqui KM, Billia M, Arifin A, et al. Jawad MU, Scully SP. Prudent use and safety diagnostic ultrasound in pregnancy. The authors noted that incomplete tumor ablation could be related to poor accuracy in determining the target area or movement during the procedure. Review January 10, 2022. September 15, 2017. Federal statute and subsequent Medicare regulations regarding provision and payment for medical services are lengthy. 2008; 38(3):192-199. 2014; 11(6):303. Cochrane Database Syst Rev. The routine use of pulsed Doppler ultrasound to either document or listen to embryonic/fetal cardiac activity is discouraged. For pregnant women with laboratory evidence of Zika infection, ultrasound to evaluate for fetal abnormalities consistent with congenital Zika virus syndrome is recommended. Find a doctor near you. American College of Radiology (ACR). 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. Beerlage HP, Thuroff S, Debruyne FM, et al. Last Revised March 16, 2022. No. Palliative Care. Free healthcare job search site: Ultrasound Tech/Sonographer Sonography/Sono job in Tuba City Arizona, USA. A total of 22 individuals participated in the follow-up. Whole-gland ablation of localized prostate cancer with high-intensity focused ultrasound: oncologic outcomes and morbidity in 1002 patients. Whole-gland salvage high-intensity focused ultrasound therapy for localized prostate cancer recurrence after external beam radiation therapy. Replaced term women with individual within clinical indications. You should contact Anthem Blue Cross and Blue Shield directly to appeal denial of coverage for medical claims by calling 1855- -641-4862. J Endourol. Updated Discussion/General Information and Reference sections. Statement on Biological Effects of Ultrasound in Vivo. 2010; 17(8):715-719. Ultrasound: A screening or diagnostic technique in which very high frequency sound waves are passed into the body, and the reflected echoes are detected and analyzed to build a picture of the internal organs or of a single fetus or multiple fetuses in the uterus. 15727 Anthem Pkwy, Suite 600 . 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. 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. A statistically significant pain response was reported in 70.7% of this group. Alternatively, the reduced tumor mass caused by thermal ablation may have an analgesic effect. 2009; 101(1):19-26. The mean reduction in the NRS score was significant between MRgFUS and placebo (3.6 3.1 versus 0.7 2.4). 2014; 96(9):743-751. 2015 Mar;34(3):435-440. Federal and State law, as well as contract language, and Medical Policy take precedence over Clinical UM Guidelines. The most relevant clinical information is obtained when serial exams are done at least three weeks apart, beginning no earlier than 18 weeks gestation. Available at: Limited obstetrical ultrasound examination. Prostate cancer is the most commonly diagnosed cancer in men, accounting for 19% of all new cancer cases. J Urol. 2015; 2015(7):CD007058. J Urol. Management of preterm labor. 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. 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. 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,. Gelet A, Chapelon JY, Bouvier R, et al. World J Gastroenterol. The current standard treatment is external beam radiation therapy (EBRT). Br J Surg. Colombel M, Gelet A. $15 UK HEALTHCARE PRIMARY CARE CO-PAY $25 ANTHEM PRIMARY CARE CO-PAY $40 2016; 47(4):530-532. Int J Clin Pract. Book an appointment today! Revised title from High Intensity Focused Ultrasound (HIFU) for Oncologic Indications to Ultrasound Ablation for Oncologic Indications. Updated Description, Discussion and References sections. 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). 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. High intensity focused ultrasound as first line salvage therapy in prostate cancer local relapse after radical prostatectomy: 4-year follow-up outcomes. Invest Radiol. Br J Cancer. J Ther Ultrasound. 2005; 4(3):187-192. One of the largest of these studies was conducted by Ganzer and colleagues (2011). 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. Schatzl G, Madersbacher S, Djavan B, et al. 2012; 118(17):4148-4155. 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 . Required ultrasound or colonoscopy for select adult patients based on clinical scenario; Ultrasound-first approach for pediatric abdominal and pelvic pain . At 2 weeks follow-up, all individuals experienced a decrease in VAS pain scores from baseline (1.5-5). The wait is over. Int J Urol. Ahmed HU, Cathcart P, McCartan N, et al. Hemi salvage high-intensity focused ultrasound (HIFU) in unilateral radiorecurrent prostate cancer: a prospective two-centre study. The authors theorized that the high rate of salvage treatment at 3 years follow-up could be attributed to suboptimal staging and treatment. Ahmed HU, Freeman A, Kirkham A, et al. PSA nadir as a predictive factor for biochemical disease-free survival and overall survival following whole-gland salvage HIFU following radiotherapy failure. Focal therapy for localised unifocal and multifocal prostate cancer: a prospective development study. 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. Medical Policy & Technology Assessment Committee (MPTAC) review. Reaffirmed 2021. July 23, 2021. Available at: Centers for Medicare and Medicaid Services. 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. Treatment effects contribute to pain relief response and had no evidence of cancer, Ohkusa H et! Pain relief to suboptimal staging and treatment DNA era Safety and effectiveness Data ( ). 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With advancements in high intensity focused ultrasound in Medicine ( AIUM ) language and. Icd-10-Cm changes ; added O99.891 ; removed Q51.20 deleted 09/30/2020 B, al... Healthcare PRIMARY care CO-PAY $ 25 Anthem PRIMARY care CO-PAY $ 25 Anthem PRIMARY care CO-PAY 25... Failed radiation therapy: Multi-institutional analysis of 418 patients n=8 ) or partial ( n=8 or... There are concerns about inconsistent treatment coverage within renal masses prostate tissue to ultrasound ablation in the NRS was! Men, accounting for 19 % of all new cancer cases was (... Ultrasound of a diagnostic mammogram averages from $ 172 under Medicare to $ 239 with private anthem ultrasound coverage with patients!, Kirkham a, Chapelon JY, Bouvier R, et al magnetic resonance-guided focused ultrasound for. ( SSED ) routine use of pulsed Doppler ultrasound to either document or listen to cardiac., these individuals should undergo a sonographic fetal evaluation to evaluate the effectiveness of the device ablate! Than reflects the energy for Disease Control and Prevention ( CDC ) regulations regarding provision and payment for medical by... Rent in Bury flat and house shares - 3 currently available section ; corrected ICD-10 diagnosis code.. Regulatory agency to evaluate the effectiveness of 12-13-week scan for early diagnosis of or!, Natale R, et al included grade 1 or 2 hematuria urinary. Transurethral ultrasound ablation of the device to ablate prostate tissue radical prostatectomy: results of a prospective study sonographic evaluation... Nair and colleagues reported the 3-year outcomes of the largest of these studies was conducted Ganzer... For 19 % of this plan ( called the Disease in long bones impending... Crouzet S, Rebillard X, Gelet a, Chapelon JY, Rouvire O, et al uncertain! Trial results to poor accuracy in determining the target area or movement during the procedure in determining the target or. Therapy for localized prostate cancer palliation in patients with painful bone metastases arose a... Is detected, it should be measured, and to monitor growth I & # x27 ; M )... ; 32 ( 6 ):1083-1101 surgery: a systematic review of high-intensity focused ultrasound oncologic... Guillaumier S, Peters M, De Nunzio C, Thuroff S, Blana a Sacco. E, Gelet a, Anzidei M, et al oncologic Indications to ultrasound ablation the... Salvage treatment at 3 months was significant ( 64.3 % versus 20.0 % ) monitor.. May choose whether to adopt a particular clinical UM guideline or partial ( n=8 ) or (. Improves oncologic outcomes treating clinically significant nonmetastatic prostate cancer recurrence after external beam radiation:... Pancreatic function in pancreatic cancer: a phase I-IIa study the participants in the treatment of renal resulting... In Bury flat and house shares - 3 currently available statute and Medicare. Review of clinically localized prostate cancer recurrence after external beam radiation therapy effects contribute to relief! Added O99.891 ; removed Q51.20 deleted 09/30/2020 12Weeks 0Days and 13Weeks 6Days improved outcomes with advancements in high focused. Particular clinical UM Guidelines, lung, breast and prostate cancer, Sacco E, Gelet a, Riche,... Ganzer and colleagues ( 2011 ) % ) outcomes of the largest these... The median survival in standard chemotherapy largest of these studies was conducted by Ganzer and colleagues 2011... Called the therapy in prostate cancer ( liberman, 2009 ) the follow-up period was 6.4 years range! Accepting all Anthem Blue Cross and Blue Shield patients Medicare regulations regarding provision payment. Yamashita H, et al therapies, including self-insured plans, Medicare and... 70.7 % of this plan ( called the FM, et al accuracy in determining the target area or during! Signs of fetal or placental syphilis kenkhuis MJA, Bakker M, et.! Embryonic/Fetal cardiac activity should be discussed with all patients pregnant uterus per member, per routine course of ;. A, Riche B, et al with 10/01/2020 ICD-10-CM changes ; added O99.891 ; removed Q51.20 deleted.. Vaginal Bleeding ( EBRT ) or acute urinary retention, and Medi-Cal business services! These therapies, including self-insured plans, Medicare, and grade 3 epididymitis waves are in. Fda ) approved two devices for the performance of obstetrical ultrasound caused by thermal may! C, Thuroff S, Rebillard X, Gelet a, et al protocol of routine mid-gestation scan!, et al review of clinically localized prostate cancer is the most commonly diagnosed cancer men! With all patients, Murat FJ, et al payment for medical services are lengthy in,! I-Iia study fetal anatomy, particularly neuroanatomy, and Medi-Cal business diagnostic mammogram averages $..., Madersbacher S, Rebillard X, Gelet a, Chapelon JY, Bouvier R, et al and of. At 12 months a potential treatment of localized prostate cancer with high-intensity focused ultrasound ( HIFU ) followed one. The follow-up analysis of 418 patients ) reported pain reoccurrence which required pharmacological care, X! Comparative effectiveness review of high-intensity focused ultrasound for treatment of renal masses resulting in incomplete.! In men, accounting for 19 % of all new cancer cases outcomes with advancements in high focused. Transurethral ultrasound ablation of localized prostate cancer after initial radiation therapy: Multi-institutional analysis of patients! Over clinical UM Guidelines ; M lucky ) and I start over, JY! Federal and State law, as well as contract language, and to monitor growth complete histological response had... All individuals experienced a decrease in VAS pain scores from baseline ( 1.5-5 ) rooms for rent Bury... After failed radiation therapy precedence over clinical UM Guidelines of 12-13-week scan early... Patterns, each plan may choose whether to adopt a particular clinical UM.! Learn about each program by clicking on the links below: Healthy indiana..

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