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Radioembolization for Primary and Metastatic Tumors of the Liver Medical Policy Revision

Effective October 15, 2014, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider certain claims for the treatment of primary and metastatic tumors of the liver with radioembolization.

Based on our guidelines of the revised medical policy Radioembolization for Primary and Metastatic Tumors of the Liver, HCPCS code S2095 or CPT® code 37243 submitted on a claim with a diagnosis that is not related to cancers of the colon and/or other digestive organs for dates of service October 15, 2014 and after will be denied since they are considered an investigational service.

This medical policy is available in our online Medical Policy Manual.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims for dates of service October 15, 2014 and after.

CPT® is a registered mark of the American Medical Association.

Published on: July 17, 2014, 06:11 a.m. ET
Last updated on: November 24, 2020, 23:19 p.m. ET