60661
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
4.14
Facility
$190.39
Non-Facility
$409.16
Documentation Required
- When billing, providers must use the most appropriate codes as of the effective date of the submission; claims submitted without covered code(s) under this Coverage Policy will be denied as not covered.
- Claims/requests must be accompanied by documentation that supports a covered indication (e.g., documentation of diagnosis of differentiated or medullary thyroid cancer; for benign nodules, documentation of compressive symptoms such as changes of voice, dysphagia, dyspnea, pain; for autonomously functioning nodules, documentation of hyperthyroidism).
- The policy lists the CPT codes to be used when criteria are met: 60660 (Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency) and 60661 (Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency).
Key Coverage Criteria
- Radiofrequency ablation (RFA) is considered medically necessary for treatment of ANY of the following:
- differentiated thyroid cancer (i.e., papillary, follicular, and oncocytic carcinoma – formerly known as Hürthle cell)
- medullary thyroid cancer
- benign thyroid nodule when BOTH of the following criteria are met: compressive symptoms (e.g., changes of voice, dysphagia, dyspnea, pain) AND limited to a single RFA treatment in a 12-month period
- autonomously functioning nodules as treatment for hyperthyroidism
- Benign cytology ononefine needle or core biopsy;and
2 Active Policies
CIGNA-RFA — Radiofrequency Ablation (RFA) Thyroid Nodules - (0575)
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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