Endoscopic Ultrasonography (EUS) [For the List of Services and Procedures That Need Preauthorization, Please Refer To
Clinical Medical Policy Department Clinical Affairs Division Endoscopic Ultrasonography (EUS) [For the list of services and procedures that need preauthorization, please refer to http://www.mcs.com.pr. Go to “Proveedores”, and clic “Políticas Médicas”.] Medical Policy: MP-SU-03-08 Original Effective Date: June 12, 2008 Revised: May 3, 2021 Next Revision: April, 2022 This policy applies to products subscribed by the following corporations, MCS Life Insurance Company (Commercial), and MCS Advantage, Inc. (Classicare) and Medical Card System, Inc., provider’s contract; unless specific contract limitations, exclusions or exceptions apply. Please refer to the member’s benefit certification language for benefit availability. Managed care guidelines related to referral authorization, and precertification of inpatient hospitalization, home health, home infusion and hospice services apply subject to the aforementioned exceptions. DESCRIPTION Endoscopy Ultrasonography (EUS) combines endoscopy and ultrasound in order to obtain images and information about the digestive tract and the surrounding tissue and organ. Endoscopy procedure is the insertion of a long flexible tube via the mouth or the rectum to visualize the digestive tract. Whereas ultrasound uses high frequency sound waves to produce images of the organs and structures inside the body such as ovaries, uterus, liver, gallbladder, pancreas and aorta, etc. Traditional ultrasound sends sound waves to the organ(s) and back with a transducer placed on the skin overlying the organs(s) of interest. Images obtained by traditional ultrasound are not always on high quality. In EUS a small ultrasound transducer is installed on the tip of the endoscope which is inserted into the upper or the lower digestive tract and one can obtain high quality ultrasound images of the organs inside the body (MedicineNet, Inc., 2021).
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