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Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors
Effective date
Not stated in the notice
Identified
Jun 20, 2026
Summary
BCBSMS updated its Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors policy on 04/06/2026. The policy description no longer includes the section on health disparities in certain solid tumor types, and the policy statements are unchanged. The code reference also removed its ICD-9 procedure and diagnosis codes.
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What to do
Action · 7 steps
01The 04/06/2026 update gives no separate effective date, so check current applicability before acting.
02Billing team: radiofrequency ablation may be considered medically necessary for localized renal cell carcinoma no more than 4 cm when preservation of kidney function is necessary, or when the individual is not considered a surgical candidate.
03Billing team: for an isolated peripheral non-small-cell lung cancer lesion no more than 3 cm, surgical resection or radiotherapy with curative intent must be considered appropriate but medical co-morbidity makes the individual unfit for those, and the tumor must be at least 1 cm from the trachea, main bronchi, esophagus, aorta, aortic arch branches, pulmonary artery, and heart.
04Billing team: for non-pulmonary tumors metastatic to the lung no more than 3 cm, there must be no evidence of extrapulmonary metastases, the tumor must be at least 1 cm from the same structures, and surgery or radiotherapy must be likely to substantially worsen lung function or the individual must not be a surgical candidate.
05No more than 3 tumors per lung should be ablated, and twelve months should elapse before a repeat ablation is considered.
06Radiofrequency ablation for osteolytic bone metastases may be considered medically necessary to palliate pain when standard treatments such as radiation or opioids have failed or the individual is a poor candidate.
07Radiofrequency ablation is considered investigational for breast tumors, lung cancer not meeting the criteria above, renal cell cancer not meeting the criteria above, osteoid osteomas that can be managed with medical treatment, initial treatment of painful bony metastases, and all other tumors outside the liver including head and neck, thyroid, pancreas, adrenal gland, ovary, and pelvic or abdominal metastases of unspecified origin.
Codes mentioned
20982329985054950592606606066176940
Original notice
Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors
bcbsms.com · Always check the source before changing claims.
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