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Performance of transient elastography more than twice per year is considered not medically necessary.

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Liver biopsy is considered the gold standard for diagnosis and management of chronic liver disease.

However, it is an invasive procedure that may result in complications.

This test is considered experimental and investigational for all other indications.

Aetna considers magnetic resonance elastography experimental and investigational for distinguishing hepatic cirrhosis from non-cirrhosis in persons with hepatitis C or other chronic liver diseases, and for all other indications because its effectiveness for these indications has not been established.

Non-invasive tests also have the potential to avoid limitations of liver biopsy, including the risk of sampling errors and inter- and intra-pathologist variability.

An assessment by the Belgian Healthcare Knowlege Center (KCE, 2016) reported that until recently, the usual examination to establish the degree of hepatic fibrosis was a histopathological examination of a liver sample taken by means of a liver biopsy.

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