Bio-Surgery: Medicinal Leech Therapy and Medical Maggots

Aetna considers medicinal leech therapy medically necessary only for poor venous drainage/venous congestion (venous outflow obstruction) and for salvage of vascularly compromised surgical flaps and replants, and considers medical maggot (larval) therapy medically necessary for debridement of non‑healing necrotic skin and soft tissue wounds, including chronic diabetic and neuropathic foot ulcers; other indications are not covered. Coverage requires documentation of the specific clinical indications (venous outflow obstruction or vascular compromise for leeches; documented non‑healing necrotic wounds for maggots).

"Medicinal leech therapy is medically necessary for salvage of vascularly compromised flaps (muscle, skin, and fat tissue surgically removed from one part of body to another)."

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