Payer PolicyActive
SURG.00139 Intraoperative Assessment of Surgical Margins During Breast-Conserving Surgery with Radiofrequency Spectroscopy or Optical Coherence Tomography
ANTHEM-SURG.00139
Anthem
Effective: April 16, 2025
Updated: December 30, 2025
Policy Summary
This policy addresses using radiofrequency spectroscopy (e.g., MarginProbe) and optical coherence tomography to assess surgical margins intraoperatively during breast-conserving surgery (lumpectomy). Anthem considers these technologies investigational and not medically necessary; therefore, they are not covered. There are no covered indications—noncoverage applies to any intraoperative, adjunctive margin assessment on lumpectomy specimens in all settings.
Coverage Criteria Preview
Key requirements from the full policy
"The use of radiofrequency spectroscopy or optical coherence tomography for intraoperative assessment of surgical margins during breast-conserving surgery is consideredinvestigational and not medica..."
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