SURG.00149 Percutaneous Ultrasonic Ablation of Soft Tissue

This policy addresses percutaneous ultrasonic ablation of soft tissue. Anthem considers this procedure investigational and not medically necessary for all indications; therefore, it is not covered. This non-coverage applies to musculoskeletal conditions such as Achilles tendinosis, lateral or medial elbow tendinosis, patellar tendinosis, and recalcitrant plantar fasciitis, and claims billed under CPT/HCPCS codes 17999, 20999, and A00149 are not covered.

"Percutaneous ultrasonic ablation of soft tissue is consideredinvestigational and not medically necessaryfor the treatment ofanycondition, including, but not limited toanyof the following musculoske..."

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