Prostate Surgeries and Interventions

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Prostate Surgeries and Interventions Page 1 of 21 UnitedHealthcare Commercial Medical Policy Effective 05/01/2022 Proprietary Information of UnitedHealthcare. Copyright 2022 United HealthCare Services, Inc. UnitedHealthcare Commercial Medica l Policy Prostate Surgeries and Interventions Policy Number: 2022T0618C Effective Date: May 1, 2022 Instructions for Use Table of Contents Page Coverage Rationale ........................................ ............................... 1 Documentation Requirements ........................................ .............. 2 Applicable Codes ........................................ .................................. 3 Description of Services ........................................ ......................... 4 Clinical 4 Food and Drug 17 References ........................................ ........................................ ... 18 Policy History/Revision Information.

In this 19-center study, 206 subjects ≥ 50 years old with an International Prostate Symptom Score (IPSS ) > 12, peak flow rate (Qmax) ≤ 12 mL/s, and prostate volume 30 cc -80 cc were randomized 2:1 to the PUL procedure or blinded sham control. IPSS improvement after PUL was 88% greater than that of sham at 3 months.

  International, Prostate, International prostate