Currently, insurance companies cover the evaluation of thyroid nodules, but radiofrequency ablation (RFA) of thyroid nodules is not a recognized benefit. Heat image-guided ablation is rarely covered, but chemical ablation with ethanol is usually approved. Unfortunately, RFA may not be covered by insurance due to its newness. RFA carries out-of-pocket costs, and doctors are working to get insurers to cover the procedure in the future.
If you need or want this procedure, UT Southwestern's patient services can help you navigate resource options. Medicare covers RFA for certain conditions if a plan-approved doctor deems it medically necessary. The criteria for approval vary depending on the condition being treated. The RFA Tumor Board at the Utah Thyroid Institute consists of experts in all specialties involved in the evaluation and treatment of thyroid nodules, including surgeons, interventional radiologists, and endocrinologists.
The procedure is performed in the office with local anesthesia and no increased risk. In one case, a hospital has taken the unique step of forming a multidisciplinary board of thyroid nodule RFA tumors to assist in the decision-making process. Patients who have symptoms of thyroid nodules will receive a comprehensive evaluation including neck ultrasound, ultrasound-guided biopsies, and radiofrequency ablation of the thyroid nodule in one place. Monchik and colleagues (200) evaluated the long-term effectiveness of RFA injection and percutaneous ethanol (EtOH) treatment of patients with local recurrence or distant focal metastases of well-differentiated thyroid cancer (WTC).
Zhao and his colleagues (201) evaluated the effectiveness of ultrasound-guided ARF (EE. (US) for localized recurrent thyroid cancers. An UpToDate review on “Diagnostic Approach and Treatment of Thyroid Nodules” (Ross, 201) states that “Ablation techniques: benign, autonomic and cystic thyroid nodules can be treated by ultrasound-guided injection of ethanol or sclerosing agents and by ultrasound-directed physical energy.” In a separate study presented at a meeting, three practitioners described their experiences with RFA in their outpatient thyroid offices in San Antonio, Texas; Santa Monica, California; and Gettysburg, Pennsylvania. The National Comprehensive Cancer Network (NCCN) guidelines on thyroid cancer (20) indicate that distant metastases from recurrent or persistent medullary thyroid carcinoma that cause symptoms can be treated with RFA.
Li and colleagues (201) evaluated the safety and efficacy of US-guided percutaneous bipolar ARF (BRFA) of benign thyroid nodules (BTN) compared to a compatible untreated control group. This new method applies internal energy to thyroid nodules to effectively destroy problem tissue without damaging the healthy external thyroid gland. The functioning thyroid lobe is preserved, the thyroid node is reduced in size and the main objectives are achieved.
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