THER-RAD.00012 Electrophysiology-Guided Noninvasive Stereotactic Cardiac Radioablation

This policy addresses electrophysiology-guided noninvasive stereotactic cardiac radioablation (also called stereotactic arrhythmia radiotherapy/STAR) using SBRT for treating cardiac arrhythmias. Anthem considers this investigational and not medically necessary; it is not covered for any indication, including drug- or ablation-refractory ventricular tachycardia and PVC-related cardiomyopathy. There are no covered indications at this time, and services billed under CPT/HCPCS codes 77299, 77373, 77399, 77435, and S2405 fall under this noncoverage.

"The use of electrophysiology-guided noninvasive stereotactic cardiac radioablation is consideredinvestigational and not medically necessaryas a treatment modality for all indications, including dru..."

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