COVERAGE: Carriers Set Limits On New Technique

Article Overview

This article reviews how Medicare carriers are approaching coverage for accelerated partial breast irradiation, a breast cancer radiation technique, while waiting for additional clinical evidence. It is relevant to oncology coders, radiation oncology practices, breast surgeons, and compliance staff who track payer policy and specialty society recommendations. The piece covers the general treatment approach, the draft local coverage determinations, and the physician society consensus criteria cited in support of those limits.