Transmyocardial and Endovascular Laser Revascularization

Aetna covers open‑chest and thoracoscopic transmyocardial laser revascularization (TMLR) (CPT 33140–33141; ICD‑10 I20.1–I20.9) as medically necessary for medically refractory, severe intractable angina when diagnostic testing shows viable ischemic myocardium not amenable to PCI or CABG and the patient has been stabilized from acute conditions (e.g., ventricular arrhythmia, decompensated CHF, recent MI) per selection criteria. Excimer laser coronary angioplasty, percutaneous TMLR, and TMLR combined with adipose‑derived stromal cells or autologous bone marrow cell therapy are considered experimental/investigational and not covered.

"TMLR plus cell therapy with adipose derived stromal cells or autologous bone marrow cells for the treatment of ischemic heart disease."

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