Percutaneous Laser Ablation of Benign and Malignant Breast Tumors
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This policy governs coverage of percutaneous laser ablation for benign and malignant breast tumors. The procedure is considered investigational for all breast tumor indications and is not covered under this medical policy, subject to applicable contract terms.
No material clinical or coverage changes in this revision.
Coverage Criteria
All breast tumor indications
The procedure is considered investigational for all benign and malignant breast tumor indications.
No covered indication is identified in this policy.
Percutaneous laser ablation is considered investigational and not covered for the treatment of any breast tumor, including benign tumors such as fibroadenoma and malignant tumors. No covered breast-tumor indication is identified under this policy.
Coding
Provider Actions
Investigational Breast Tumor Ablation
Percutaneous laser ablation is investigational and may be denied for treatment of any benign or malignant breast tumor, including fibroadenoma and breast cancer. There is insufficient evidence that the procedure improves health outcomes, and no evidence-based clinical guidelines recommend it for any type of breast tumor.
- Review requests for percutaneous laser ablation of benign or malignant breast tumors carefully; coverage may be denied as investigational.
Background
Percutaneous laser ablation uses an image-guided laser fiber inserted through the skin to deliver focused energy that heats and destroys breast tumor tissue. The technique has been studied for fibroadenomas and malignant breast tumors as a minimally invasive alternative to surgery. However, evidence remains insufficient: benign-tumor data are sparse, malignant-tumor studies are limited and heterogeneous, and no high-quality studies directly compare the procedure with surgery.
Definitions
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