CG-SURG-78 Cryosurgical, Radiofrequency, Microwave, or Percutaneous Ethanol Ablation to Treat Solid Tumors in the Liver

Addresses liver-directed local ablation techniques—cryosurgical ablation, radiofrequency ablation (RFA), microwave ablation (MWA), and percutaneous ethanol injection (PEI)—for solid liver tumors. Medically necessary for individuals with primary or metastatic hepatic tumors when all policy clinical criteria are met; not medically necessary when criteria are not met. Coverage is limited to locally ablating liver tumors and requires meeting all indication-specific selection criteria outlined in the policy; uses outside these indications are not covered.

"A."

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