C9782, Blinded procedure for new york heart association (nyha) class ii or iii heart
HCPCS/CPT
Prior Authorization
No Prior Auth Required
No active coverage policies found for this code (low confidence)
Documentation Required
- No explicit documentation requirements (medical records, test results, prior authorization criteria) are specified in the provided document text.
- No explicit documentation requirements, billing criteria, ICD-10 or CPT codes, or specific record-keeping instructions are provided in this document.
- The document repeatedly calls for clinical-trial–quality documentation (well-defined end-points, power calculations, appropriate statistical methods) for future studies but does not specify documentation required for coverage.
- Claims must be submitted with the most appropriate and covered diagnosis and/or procedure codes; services billed without covered codes under this Coverage Policy will be denied.
Key Coverage Criteria
- No explicit covered indications are stated in this document. The text describes investigational/experimental uses of stem cell and cell-based therapies in multiple clinical scenarios, including:
- Ischemic heart disease / acute myocardial infarction (AMI) — investigations of intracoronary or intramyocardial delivery of bone marrow mononuclear cells (BMCs/BM-MNC), mesenchymal stem cells (MSCs), cardiosphere-derived cells (CDCs), autologous skeletal myoblasts (ASM), and allogeneic MSCs.
- Chronic ischemic heart disease / heart failure (including ischemic cardiomyopathy, advanced heart failure, reduced LVEF) — trials of transendocardial, intracoronary, and intramyocardial delivery of various cell types (BMC, MSC, cardiopoietic cells, CDCs, skeletal myoblasts).
- Peripheral arterial disease (PAD) and critical limb ischemia (CLI) — intra-arterial or intramuscular implantation/infusion of autologous bone marrow mononuclear cells (BMMNCs / mBMCs) or peripheral blood mononuclear cells.
- Dilated cardiomyopathy (DCM) — intracoronary infusion of BMMCs or BMSCs evaluated in small randomized studies.
- Pediatric cardiomyopathy — small pilot intracoronary stem cell trials in children.
7 Active Policies
CIGNA-0287, Cell-based Therapies for Cardiac and Peripheral Arterial Disease
AETNA-CPB-0599, Autologous Skeletal Myoblast/Mononuclear Bone Marrow Cell Transplantation
SUR703.027, Progenitor Cell Therapy for the Treatment of Damaged Myocardium Due to Ischemia
BCBSIL-SUR703.027, Progenitor Cell Therapy for the Treatment of Damaged Myocardium Due to Ischemia
BCBSMT-SUR703.027, Progenitor Cell Therapy for the Treatment of Damaged Myocardium Due to Ischemia
Related Codes
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