CG-SURG-75 Transanal Endoscopic Microsurgical (TEM) Excision of Rectal Lesions

This policy addresses transanal endoscopic microsurgery (TEM) for excision of rectal lesions, including rectal tumors and polyps. TEM is medically necessary when the lesion is appropriate for local excision but is too proximal (high) to be reached using conventional transanal excision; it is not medically necessary when these criteria are not met. Coverage is limited to cases where local excision is appropriate and standard transanal access is not feasible, recognizing that more advanced tumors may require alternative surgical approaches.

"Transanal endoscopic microsurgery (TEM) is consideredmedically necessaryfor treatment of rectal lesions including rectal tumors and rectal polyps that are appropriate for treatment by local excisio..."

Sign up to see full coverage criteria, indications, and limitations.