0546T — Rf spectrsc ntraop mrgn asmt
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Documentation Required
- Documentation that the test is technically reliable for the intended use.
- Documentation that the test is clinically valid for assessing surgical margins in the specified clinical context.
- Documentation that the test is clinically useful for decision-making during breast-conserving surgery.
- Medical record/pathology/operative note must state whether the lesion was re-excised; if it was not re-excised this must be specifically documented.
Key Coverage Criteria
- Intraoperative assessment of surgical margins during breast-conserving surgery for localized breast cancer to help achieve tumor‑free margins.
- Use of an intraoperative device to detect positive surgical margins during breast-conserving surgery to identify tumor at the margin
- Use of a margin-detection device intended to reduce need for re-excision by identifying residual tumor intraoperatively
- Intraoperative assessment of margins on the main lumpectomy specimen during breast-conserving surgery to identify tissue likely malignant versus benign.
- Use to help achieve clear surgical margins in the initial lumpectomy and reduce the need for a second excision procedure.
- Intraoperative adjunctive use with standard methods (e.g., intraoperative imaging and palpation) for patients undergoing lumpectomy for previously diagnosed breast cancer.
5 Active Policies
BCBSIL-SUR701.037 — Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery
BCBSMT-SUR701.037 — Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery
BCBSNM-SUR701.037 — Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery
BCBSOK-SUR701.037 — Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery
Related Codes
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