High Intensity Focused Ultrasound

Aetna covers HIFU (CPT 55880) as medically necessary only for radio‑recurrent prostate cancer (ICD‑10 C61) when there is no metastatic disease and documented selection criteria are met. HIFU is considered experimental/investigational (not covered) for benign thyroid nodules, acute adult fractures (as fracture treatment), abdominal wall endometriosis, adenomyosis‑related symptoms, Alzheimer’s disease, benign prostatic hyperplasia, and other indications due to insufficient evidence.

"Aetna considers high intensity focused ultrasound (HIFU) medically necessary for radio-recurrent prostate cancer in the absence of metastatic disease."

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