anthem ultrasound coverage

Insurance coverage for whole-breast ultrasound is evolving. The remaining 11.1% (2/18) reported pain reoccurrence which required pharmacological care. Salvage radical prostatectomy following primary high intensity focused ultrasound for treatment of prostate cancer. Boccon-Gibod L, Djavan WB, Hammerer P, et al. Magnetic resonance-guided focused ultrasound for patients with painful bone metastases: phase III trial results. Klotz L, Pavlovich CP, Chin J, et al. 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. Kaur A, Kaur A. Transvaginal ultrasonography in first trimester of pregnancy and its comparison with transabdominal ultrasonography. 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. Updated Coding section with additional diagnosis codes D25.0-D25.9, O26.872-O26.879, O99.210-O99.213, O99.810. 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 location you tried did not return a result. Hinyokika Kiyo. 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). Comparing high-intensity focal ultrasound hemiablation to robotic radical prostatectomy in the management of unilateral prostate cancer: a matched-pair analysis. 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. Focal therapy for localized prostate cancer: a phase I/II trial. 2018; 6:8. July 23, 2021. Statement on Biological Effects of Ultrasound in Vivo. Mol Urol. 2008; 38(3):192-199. A total of 22 individuals participated in the follow-up. Added medically necessary indication when there is a known or suspected exposure to the Zika virus to the Clinical Indications section. NOTE: Information about the cost of this plan (called the . 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. 2011; 185(3):862-868. In brief: classifications in brief: Mirels' classification: metastatic disease in long bones and impending pathologic fracture. Bone metastasis: When cancer cells have broken off from the primary tumor and have settled and started growing on bones. 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. Updated Coding section with 10/01/2020 ICD-10-CM changes; added O99.891; removed Q51.20 deleted 09/30/2020. Shi Y, Ying X, Hu X, et al. In an intent-to-treat analysis, 63% (72/115) were reported to have a complete histological response and had no evidence of cancer. The price of a diagnostic mammogram averages from $172 under Medicare to $239 with private insurance. Bonekamp and associates (2019) performed a quantitative analysis of viable prostate tissue volume reduction at 12 months post-procedure. Ultrasound Obstet Gynecol. Eur Urol. J Ultrasound Med. In Ohio: Community Insurance Company. 2014; 65(5):907-914. You can choose your preferred appointment time on our website, www.ultrasound-first.com, or you can call Lexie at the office (314-782-2034) if you need help or have any questions. Updated September 20, 2021. Errico A. Routine ultrasound in late pregnancy (after 24 weeks' gestation). 2022 Prenatal ultrasound diagnosis (Dx) codes Please note that this information is a guideline. 2004; 63(2):297-300. Find top doctors who perform Rectal Ultrasound near you in Anthem, AZ. Post-treatment biopsies were available in 77% of subjects. J Endourol. Obstetric Care Consensus. Ultrasound during pregnancy is used to assess the uterus, umbilical cord and placenta, as well as fetal anatomy and well-being. MPTAC review. 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. Grade 3 (n=1) and grade 2 (n=3) AEs related to urinary retention and urinary tract infection were reported. MPTAC review. Guideline for the management of clinically localized prostate cancer: 2007 update. 2018. Improved outcomes with advancements in high intensity focused ultrasound devices for the treatment of localized prostate cancer. Visit our official site today for more details. At 12 months, the majority of participants (10/11) were cancer free in the ablated area and maintained a low stable PSA. Eur Urol. 2011; 108(8 Pt 2):E196-E201. In brief: classifications in brief: Mirels' classification: metastatic disease in long bones and impending pathologic fracture. Br J Surg. Revised 2020. However, comparisons involving HIFU were limited to radical prostatectomy because of a lack of studies comparing HIFU to other therapies. Updated Discussion/General Information, Coding and Reference sections. HIFU treatment is combined with a visualization method, frequently MR guidance, to better guide treatment in real time. Correlation of prostate-specific antigen nadir and biochemical failure after high-intensity focused ultrasound of localized prostate cancer based on the Stuttgart failure criteria - analysis from the @-Registry. Inclusion or exclusion of a procedure, diagnosis or device code(s) does not constitute or imply member coverage or provider reimbursement policy. Li CC, Wang YQ, Li YP, Li XL. 2015; 102(8):873-882. Ultrasound Tech in San Antonio, Texas, United States. New reimbursement policy: Maternity Services and Multiple Delivery (Professional) Beginning with dates of service on or after December 1, 2019, Anthem's current Routine Obstetrics policy will be retired and will be replaced by the new Maternity Services policy and the new Multiple Delivery policy. Pain palliation in patients with bone metastases using magnetic resonance-guided focused ultrasound with conformal bone system: a preliminary report. 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. 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. 2011; 185(4):1246-1254. Nat Rev Clin Oncol. Salvage high-intensity focused ultrasound (HIFU) for locally recurrent prostate cancer after failed radiation therapy: Multi-institutional analysis of 418 patients. Ultrasound averages range from $54 to $100. Ann Surg Oncol. Indiana Medicaid. Pathological, oncologic and functional outcomes of a prospective registry of salvage high intensity focused ultrasound ablation for radiorecurrent prostate cancer. 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. 2014; 11(6):303. In some states, insurance must cover . The new Multiple Delivery policy has the same . J Urol. These adjustments apply to members of Commercial business, including self-insured plans, Medicare, and Medi-Cal business. Uddin Ahmed H, Cathcart P, Chalasani V, et al. 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 . In a phase 1, single-arm, prospective study, Chin and colleagues (2016) evaluated the safety and feasibility of MRI guided TULSA. 2004; 63(4):625-629. Screening for Fetal Aneuploidy. Inclusion or exclusion of a procedure, diagnosis or device code(s) does not constitute or imply member coverage or provider reimbursement policy. Shoji S, Nakano M, Nagata Y, et al. 2012; 116(3):201-205. Pregnant Women. CT, digital radiography, ultrasound, mammography and DEXA equipment at each of our outpatient centers. Updated Discussion/General Information and Reference sections. One of the largest of these studies was conducted by Ganzer and colleagues (2011). Prostate Cancer. Yutkin V, Ahmed HU, Donaldson I, et al. Reaffirmed 2021. ; AUA Prostate Cancer Clinical Guideline Update Panel. Adult Cancer Pain (V2.2022). Initial document development. AIUM Practice Parameter for the Performance of Detailed Second- and Third-Trimester Diagnostic Obstetric Ultrasound Examinations. ACOG Practice Bulletin Number 171. 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 . Eur Urol. The current evidence is insufficient to support the use of HIFU as a generally accepted oncological treatment. Updated Coding section with 10/01/2018 ICD-10-CM diagnosis code changes; added Q51.20-Q51.28, Z20.821. Bonekamp D, Wolf MB, Roethke MC, et al. Late complications included occurrences of stenosis (9%) and fistula (0.4%). Prostate Cancer Prostatic Dis. HIFU was comparable to the median survival in standard chemotherapy. 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 Number 7. 2021; 127(5):544-552. 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. HIFU has been proposed as a treatment for multiple oncologic conditions. Summary of Safety and Effectiveness Data (SSED). The sound wave echoes are recorded and displayed as a real-time visual image. In the 25 participants that were able to tolerate a complete treatment, 72% (18/25) reported significant pain reduction of at least 2 points on the VAS scale, 24% (6/25) reported no reduction in pain and 4% (1/25) reported an increase in pain levels. 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