Transurethral Waterjet Ablation of the Prostate
L38682
Transurethral waterjet ablation of the prostate is covered once per lifetime for patients with LUTS due to BPH who meet all criteria: prostate volume 30–150 mL, IPSS ≥12, Qmax ≤15 mL/s, and failure/contraindication/intolerance to at least 3 months of conventional medical therapy. Coverage requires use of an FDA-approved/cleared device and documentation of required tests and history; exclusions include BMI ≥42 kg/m2, known or suspected prostate cancer (or PSA >10 ng/mL without a negative biopsy within 6 months), active infection, certain bladder/urethral conditions, damaged external sphincter, allergy to device materials, and inability to safely stop anticoagulants/antiplatelet agents.
"Diagnosis of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH)."
Sign up to see full coverage criteria, indications, and limitations.