Cryosurgical Ablation of Primary or Metastatic Liver Tumors

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©2014 Blue Cross and Blue Shield of Louisiana An independent licensee of the Blue Cross and Blue Shield Association 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 Blue Cross and Blue Shield of Louisiana. Page 1 of 10 Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc.(collectively referred to as the “Company”), unless otherwise provided in the applicable contract. Medical technology is constantly evolving, and we reserve the right to review and update Medical Policy periodically.

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Cryosurgical Ablation of Primary or Metastatic Liver Tumors

When Policy Topic is covered Cryosurgical ablation of primary liver tumors may be considered medically necessary for patients who meet ALL of the following criteria:  have unresectable primary hepatocellular carcinoma;  no detectable extrahepatic metastasis;  5 or fewer lesions present;  no single lesion is more than 5cm in diameter;  intra-operative ultrasound monitoring and localization ...

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Cryosurgical Ablation of Primary or Metastatic Liver Tumors

Background/Overview Hepatic tumors can be due to primary liver cancer or metastases to the liver from nonhepatic primary tumors. Primary liver cancer can arise from hepatocellular tissue (hepatocellular carcinoma [HCC]) or intrahepatic biliary ducts (cholangiocarcinoma). Multiple tumors metastasize to the liver, but there is particular interest in the treatment of hepatic metastases from colore...

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تاریخ انتشار 2014