Change in Coverage for CPT Code 0184T

Date Issued: 6/21/2018

Starting on August 30, 2018, CPT code 0184T; excision of rectal tumor, transanal endoscopic microsurgical approach (TEMS), including muscularis propria (full thickness) will no longer be covered for Medicaid and Commercial plan members because this testing is considered experimental and/or investigational (E&I) as there is insufficient evidence of therapeutic value.