Radiofrequency ablation of primary, inoperable (eg, due to location of lesion[s] and/or comorbid conditions), hepatocellular carcinoma may be considered medically necessary under the following conditions:
as a primary treatment of hepatocellular carcinoma meeting the Milan criteria (a single tumor of ≤5 cm or up to 3 nodules <3 cm). as a bridge to transplant, where the intent is to prevent further tumor growth and to maintain an individual's candidacy for liver transplant. Radiofrequency ablation as a primary treatment of inoperable hepatic metastases may be considered medically necessary under the following conditions: metastases are of colorectal origin and meet the Milan criteria (a single tumor of ≤5 cm or up to 3 nodules <3 cm). metastases are of neuroendocrine origin and systemic therapy has failed to control symptoms. Radiofrequency ablation of primary, inoperable, hepatocellular carcinoma is considered investigational under the following conditions: when there are more than 3 nodules or when not all sites of tumor foci can be adequately treated. when used to downstage (downsize) hepatocellular carcinoma in individuals being considered for liver transplant. Radiofrequency ablation of primary, operable hepatocellular carcinoma is investigational. Radiofrequency ablation for hepatic metastasis is considered investigational for: hepatic metastases from colorectal cancer or neuroendocrine tumors that do not meet the criteria above; and for hepatic metastases from other types of cancer except colorectal cancer or neuroendocrine tumors.
