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Blue Cross & Blue Shield of MississippiAll Plans · Coverage · Medical Policy · OB-GYN, Oncology, NeurologyMedium impact

Magnetic Resonance-Guided Focused Ultrasound

Effective date
Not stated in the notice
Identified
Jun 20, 2026

Summary

Magnetic resonance-guided focused ultrasound may be considered medically necessary for pain palliation in adults with metastatic bone cancer who have failed or are not candidates for radiotherapy, and for medicine-refractory essential tremors. It is considered investigational for uterine fibroids, for other tumors such as brain, prostate, breast, and desmoid tumors, and for medication-refractory tremor dominant Parkinson disease. The policy history notes that CPT code 61715 for MRI guided focused ultrasound high intensity stereotactic intracranial ablation was effective 01/01/2025.

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What to do

Action · 4 steps
01Billing team: Pain palliation for adults with metastatic bone cancer who failed or are not candidates for radiotherapy, and treatment of medicine-refractory essential tremors, may be considered medically necessary.
02Treatment of uterine fibroids, other tumors, and medication-refractory tremor dominant Parkinson disease is investigational, and investigational services are not considered medically necessary.
03Code 0398T is listed as deleted 12/31/2024.
04BCBSMS makes no payment for services that are not documented to be Medically Necessary.

Codes mentioned

61715C41.0C41.1C41.2C41.3C41.4C40.00C40.02C40.10C40.12C40.20C40.22C40.30C40.32C79.51C79.52G25.0

Original notice

Magnetic Resonance-Guided Focused Ultrasound
bcbsms.com · Always check the source before changing claims.
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Related policy hubs

Blue Cross & Blue Shield of Mississippi policiesOB-GYNOncologyNeurologyCode 61715Code C41.0Code C41.1Code C41.2Code C41.3Code C41.4Code C40.00Code C40.02Code C40.10Code C40.12Code C40.20Code C40.22Code C40.30Code C40.32Code C79.51Code C79.52Code G25.0

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