Laser Interstitial Tumor Therapy (LITT)

This policy covers MRI‑guided Laser Interstitial Tumor Therapy (LITT) — including intracranial LITT (CPT 61736/61737) and select MRI/ultrasound‑guided focal prostate ablation (CPT 0655T) — for medically refractory epilepsy with well‑defined, LITT‑accessible epileptogenic foci and for recurrent or progressive, surgically inaccessible brain tumors or radiation necrosis when open resection is not feasible or tolerated. Coverage requires a multidisciplinary treatment plan agreed by at least two specialists and performance by a neurosurgeon with procedure‑specific training using FDA‑cleared devices per labeling; LITT is considered experimental/investigational for many extracranial uses (e.g., liver, lung, pancreas, adrenal and most prostate indications), is contraindicated in patients unable to undergo MRI, and is subject to FDA safety alerts regarding MR thermometry.

"LITT for epilepsy when the individual has disabling seizures despite trials of ≥2 antiepileptic drug regimens (medically refractory epilepsy) and there are well-defined epileptogenic foci accessibl..."