Clinical Coverage Policies

  • 11A-1, Hematopoietic Stem-Cell or Bone Marrow Transplantation for Acute Lymphoblastic Leukemia (ALL)
  • 11A-2, Hematopoietic Stem-Cell and Bone Marrow Transplant for Acute Myeloid Leukemia)
  • 11A-3, Hematopoietic Stem-Cell & Bone Marrow Transplantation for Chronic Myelogenous Leukemia
  • 11A-5, Allogeneic Hematopoietic & Bone Marrow Transplant for Genetic Diseases and Acquired Anemias
  • 11A-6, Hematopoietic Stem-Cell & Bone Marrow Transplantation in the Treatment of Germ Cell Tumors
  • 11A-7, Hematopoietic Stem-Cell & Bone Marrow Transplantation for Hodgkin Lymphoma
  • 11A-8, Hematopoietic Stem-Cell Transplantation For Multiple Myeloma and Primary Amyloidosis
  • 11A-9, Allogeneic Stem-Cell & Bone Marrow Transplantation for Myelodysplastic Syndromes & Myeloproliferative Neoplasms
  • 11A-10, Hematopoietic Stem-Cell & Bone Marrow Transplantation for Central Nervous System (CNS) Embryonal Tumors & Ependymoma
  • 11A-11, Hematopoietic Stem-Cell & Bone Marrow Transplant for Non-Hodgkin’s Lymphoma
  • 11A-14, Placental and Umbilical Cord Blood as a Source of Stem Cells
  • 11A-15, Hematopoietic Stem-Cell Transplantation for Solid Tumors of Childhood
  • 11A-16, Hematopoietic Stem-Cell Transplantation for Chronic lymphocytic leukemia (CLL) and Small lymphocytic lymphoma (SLL)

12B, Human Immunodeficiency Virus (HIV) Case Management

6A, Routine Eye Exam and Visual Aids for Recipients Under Age 21