20982
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
6.84
Facility
$321.65
Non-Facility
$3482.38
Documentation Required
- No documentation requirements are stated in the provided document text.
- No explicit documentation requirements are stated in this document excerpt.
- Please refer to CMS Medicare Coverage Database for the most current applicable CMS National Coverage Determination (NCD)/Local Coverage Determination (LCD)/Local Coverage Article (LCA). Refer to CMS website for the most current applicable CMS Online Manual System (IOMs) and Transmittals.
- No specific documentation requirements, covered indications, or frequency/clinical criteria are stated in this document.
Key Coverage Criteria
- Unlisted procedure, breast (CPT 19499)
- Inferred: Treatment considerations for metastatic liver lesions or other focal hepatic tumors (references to liver cancer guidance imply relevance).
- Radiofrequency tumor ablation (RFA) is a technique that uses alternating electric current delivered via an electrode inserted into a tumor that creates heat to destroy cancer cells.
- Clinicians use imaging technology (eg, computed tomography, magnetic resonance imaging, ultrasound) to guide placement of the electrode either percutaneously or during laparoscopic surgery.
- RFA is typically used alone, as either a primary or palliative treatment, for a variety of different oncologic conditions.
- RFA can be combined with other locoregional treatments, such as transarterial chemoembolization (TACE), to increase its efficacy.
2 Active Policies
HUMANA-RADIOFREQUENCY-TUMOR-ABLATION-MA — Radiofrequency Tumor Ablation - Medicare Advantage
ANTHEM-CG-SURG-61 — CG-SURG-61 Cryosurgical, Radiofrequency, Microwave or Laser Ablation to Treat Solid Tumors Outside the Liver
Related Codes
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