Titanium Rib

Aetna covers the VEPTR (Titanium Rib) as medically necessary only for treating thoracic insufficiency syndrome (TIS) in skeletally immature patients—e.g., flail chest with TIS, rib-fusion/scoliosis with TIS, hypoplastic thorax syndromes (achondroplasia, Ellis‑van Creveld, Jarcho‑Levin, Jeune), and scoliosis only when it results in TIS—when selection criteria are met. VEPTR is excluded as investigational for scoliosis without TIS and other indications (e.g., Poland syndrome, kyphosis), is limited to skeletally immature patients, and must not be used when FDA contraindications are present (absence of proximal ribs, absent diaphragmatic function, age <6 months or beyond skeletal maturity, inadequate soft tissue/bone strength, operative-site infection, or material allergy); there is no specific CPT/HCPCS code.

"Clinical evidence cited in the policy documents substantial complication and reoperation rates; the policy restricts coverage to the defined indication (TIS in skeletally immature patients) and doe..."