Autoimmune diseases arise from an abnormal immune response of the body against substances and tissues normally present in the body.
HCT is the transplantation of multipotent hematopoietic stem cells; cells can be autologous (the individual's own stem cells are used) or allogeneic (the stem cells come from a donor).
Autologous HCT may be considered medically necessary as a treatment of systemic sclerosis/scleroderma when ALL of the following criteria are met:
Autologous HCT for all other autoimmune diseases is considered experimental/investigation and therefore non-covered due to lack of supporting published peer reviewed literature.
Individuals with systemic sclerosis/scleroderma AND internal organ involvement indicated by the following should not be considered for autologous HCT:
Autologous HCT performed in individuals with internal organ involvement, as defined above, is considered not medically necessary.
Allogeneic HCT is considered experimental/investigational and therefore non-covered as a treatment of all autoimmune diseases due to lack of supporting published peer reviewed literature.