Transcatheter Arterial Chemoembolization to Treat Primary or Metastatic Liver Malignancies

This policy covers transcatheter arterial chemoembolization (TACE) for treatment of primary and metastatic liver malignancies, including unresectable hepatocellular carcinoma confined to the liver (without portal vein thrombosis), symptomatic liver-dominant metastases (e.g., neuroendocrine or uveal melanoma), intrahepatic cholangiocarcinoma, and select neoadjuvant/adjuvant or bridge-to-transplant indications. Major limitations require adequate portal vein patency and non–Child-Pugh C liver function, bridge-to-transplant candidates must meet tumor size/number and no extrahepatic disease/vascular invasion criteria (single <5 cm or ≤3 tumors each <3 cm), and TACE is investigational for indications not explicitly listed and carries risks such as postembolization syndrome and hepatic insufficiency.

"Transcatheter arterial chemoembolization (TACE) for treatment of primary or metastatic liver malignancies."