For dates of services on or
after October 1, 2009, coverage for prenatal surgical intervention
of temporary tracheal occlusion of Congenital Diaphragmatic Hernia
(CDH) for fetuses with a prenatal diagnosis of CDH (CPT procedure
code S2400), shall be determined on a case-by-case basis, based
on the Rare Disease policy. Procedural guidelines for review of
rare disease are contained in
Chapter 1, Section 3.1.
Note: Non-directive counseling prior
to any fetal surgery or procedure is an expected component of good
clinical practice and is integrated into the appropriate office
visit and is not separately reimbursed. Additional behavioral health
care interventions are covered (e.g., psychotherapy, or services
of a pastoral counselor), when rendered in accordance with TRICARE
policy including
Chapter 7, Sections 3.8 and
3.11.