High Intensity Focused Ultrasound (HIFU) - (0274)

HIFU is covered only as salvage therapy for recurrent localized prostate cancer after radiation failure and MRgFUS is covered only for pain palliation of metastatic bone cancer when radiotherapy has failed or is contraindicated; all other HIFU/MRgFUS uses are not medically necessary and MR‑guided TULSA is experimental/investigational. Key requirements: prostate HIFU requires a recent positive repeat TRUS biopsy and absence of distant metastases (candidate for local therapy only) with supporting documentation, and MRgFUS for bone pain requires documented radiotherapy failure or contraindication plus appropriate coding and clinical records.

"High-intensity focused ultrasound (HIFU) is considered medically necessary as a treatment for recurrent localized prostate cancer following the failure of radiation therapy when BOTH of the followi..."

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