Cryoablation - Medicare Advantage

This policy addresses cryoablation for cutaneous lesions—principally squamous cell carcinoma (SCC) and similar accessible skin tumors—using indications defined by lesion depth, histologic features, and NCCN risk stratification (low, high, very high). It applies to specified patient/lesion profiles (e.g., primary/nonrecurrent, no perineural invasion, well‑defined small trunk/extremity lesions and certain high‑risk scenarios such as recurrent or immunosuppressed patients) per the listed criteria. Major limitations: the document is a CMS/MAC reference that does not itself establish medical necessity or frequency limits, coverage depends on applicable NCD/LCD and local MAC jurisdiction, and some techniques/devices (eg, dipstick) may be inadequate for deeper or non‑accessible lesions.

"No documentation requirements are stated in this document excerpt."

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