Microwave Tumor Ablation

Microwave tumor ablation (image-guided percutaneous, laparoscopic, thoracoscopic, or open thermal ablation using microwave energy) is covered for primary or metastatic hepatic and pulmonary tumors when policy-specific clinical criteria are met. Coverage is limited to unresectable lesions or patients ineligible for surgery (e.g., liver: single tumor ≤5 cm or up to 3 nodules ≤3 cm; lung: tumors ≤3 cm), is subject to the member’s benefit plan, excludes other tumor sites as experimental, and requires adherence to size/nodule limits and precautions (e.g., pregnancy and implanted electronic devices).

"Microwave ablation of primary or metastatic hepatic tumors may be considered medically necessary when policy-specific clinical criteria are met."

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