BlueCross BlueShield of Tennessee Medical Policy Manual

Electromagnetic Navigation Bronchoscopy

DESCRIPTION

Electromagnetic navigation bronchoscopy (ENB) is a proposed enhancement to standard bronchoscopy that provides a three-dimensional roadmap of the lungs and real-time navigation to aid the physician in guiding endoscopic tools in the pulmonary tract.  The purpose of ENB is to allow navigation to distal regions of the lungs. Information about the position of a steerable bronchoscope probe allows transbronchial forceps to biopsy suspicious lesion(s) and allows for placement of fiducial markers.

POLICY

IMPORTANT REMINDERS

ADDITIONAL INFORMATION 

According to the 2013 ACCP (American College of Chest Physicians) task force, the strength of the evidence for the use of ENB is a recommendation of Grade 1C, defined as “strong recommendation, low quality or very low-quality evidence”.

SOURCES

American College of Chest Physicians. (May, 2013). Establishing the diagnosis of lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Retrieved December 8, 2015 from the National Guideline Clearinghouse (NGC: 9875).

BlueCross BlueShield Association. Medical Policy Reference Manual. (6:2016). Electromagnetic navigation bronchoscopy (7.01.122). Retrieved November 11, 2016 from BlueWeb. (20 articles and/or guidelines reviewed)

Diken, Ӧ. E., Karnak, D., Çiledağ, A., Ceyhan, K., Atasoy, Ç., Akyar, S., & Kayacan, O. (2015). Electromagnetic navigation-guided TBNA vs conventional TBNA in the diagnosis of mediastinal lymphadenopathy. The Clinical Respiratory Journal, 9 (2), 214-220. Abstract retrieved December 8, 2015 from PubMed database.

Loo, F., Halligan, A., Port, J., and Hoda, R. (2014, March) The emerging technique of electromagnetic navigation bronchoscopy-guided fine-needle aspiration of peripheral lung lesions. Cancer Cytopathology. 2014; 122:191-9.

Seijo, L., de Torres, J., Lozano, M., Bastarrika, G., Alcaide, A., Lacunza, M., et al. (2010). Diagnostic yield of electromagnetic navigation bronchoscopy is highly dependent on the presence of a Bronchus sign on CT imaging: Results from a prospective study. Chest, 138 (6), 1316-1321. (Level 3 evidence)

U.S. Food and Drug Administration. (2009, May) Center for Devices and Radiological Health. 510(k) Premarket notification database K 091160. Retrieved March 18, 2011 from http://www.fda.gov.

U.S. Food and Drug Administration. (2009, May) Center for Devices and Radiological Health. 510(k) Premarket notification database K 091934. Retrieved March 18, 2011 from http://www.fda.gov.

U.S. Food and Drug Administration. (2009, May) Center for Devices and Radiological Health. 510(k) Premarket notification database K 092365. Retrieved March 18, 2011 from http://www.fda.gov.

Zhang, W., Chen, S., Dong, X., & Lei, P. (2015). Meta-analysis of the diagnostic yield and safety of electromagnetic navigation bronchoscopy for lung nodules. Journal of Thoracic Disease, 7 (5), 799-809. (Level 1 evidence)

ORIGINAL EFFECTIVE DATE:  9/11/2011

MOST RECENT REVIEW DATE:  1/12/2017  

ID_BA

Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.

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