NCDActive
Ultrasonic Surgery
NCD5
Effective: January 1, 1966
Updated: December 31, 2025
Policy Summary
Ultrasonic surgery is reimbursable when medically necessary to treat severe, recurrent vertigo due to Meniere's syndrome (ICD-10 H81.0), generally performed on the inner ear via lateral semicircular canal or round window. Operative documentation must record diagnosis, approach, anesthesia, and presence of a surgeon plus a trained technician observing inner ear reaction (nystagmus); the procedure is usually completed in a single treatment, with repeats considered rare and exceptional.
Coverage Criteria Preview
Key requirements from the full policy
"Ultrasonic surgery is covered when required to treat patients with severe and recurrent episodes of vertigo due to Meniere's syndrome."
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