Hyperthermia Therapy

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Blue Cross and Blue Shield of Illinois Provider Manual HMO Scope of Benefits Section 2020 Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association BCBSIL Provider Manual — June 2020 1 Hyperthermia Therapy Benefit Hyperthermia Therapy is in benefit if determined medically necessary by the Primary Care Physician. Interpretation Hyperthermia can be administered using local and whole-body techniques. Local hyperthermia involves elevating the temperature of superficial or subcutaneous tumors while sparing surrounding normal tissue, using either external or interstitial modalities. Local hyperthermia is usually used (but is not limited to) in combination with radiation or chemotherapy, for the treatment of members with primary or metastatic cutaneous or subcutaneous superficial malignancies who have not responded to previous therapy or are not candidates for conventional therapy. Whole body hyperthermia requires the member to be placed under either general anesthesia or deep sedation. The member's body temperature is raised to 108° F by packing the member in hot water blankets or a hyperthermia suit and allowing hot water to flow through the wrap. The elevated body temperature is maintained for a period of four hours while the essential body functions are closely monitored. Approximately one hour is required for a “cooling off" period after which the member is constantly monitored for a minimum of twelve hours. Paid by Professional Charges IPA Inpatient and/or Outpatient Surgical Facility Charges HMO BCBSIL Provider Manual — June 2020 2 .

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