Criteria
Coverage is subject to the specific terms of the member's benefit plan.
Off-label applications of chelation therapy or chemical endarterectomy are considered experimental/investigational because it is not scientifically supported for efficacy or safety and, therefore, is non-covered, including, but not limited to
ANY
of the following:
-
Alzheimer disease;
and
-
Arthritis;
and
-
Atherosclerosis;
and
-
Autism;
and
-
Coronary artery disease (CAD);
and
-
Diabetes;
and
-
Multiple Sclerosis (MS);
and
-
Peripheral vascular disease (PVD);
and
-
Rheumatoid arthritis;
and
- Secondary prevention in patients with myocardial infarction (MI).
When the chelation or chemical endarterectomy is not covered, all related services are also not covered (e.g., E/M, lab work, infusion services, administration, etc.).
Procedure Codes
J0470 | J0600 | J0895 | J3520 | M0300 | S9355 |
