CG-MED-90 Chelation Therapy

This policy addresses chelation therapy and deems it medically necessary when there are relevant clinical findings and a probable exposure history, with laboratory confirmation of heavy metal toxicity, including: disorders of iron metabolism (primary or secondary hemochromatosis), lead overload, disorders of copper metabolism (e.g., Wilson’s disease), or confirmed arsenic, mercury, iron, copper, or gold poisoning (including from long-term exposure). It is not medically necessary for any other indications when these criteria are not met; coverage requires documented lab confirmation plus clinical and exposure evidence and does not extend to investigational or non-toxicity-related uses.

"Chelation therapy is consideredmedically necessarytreatment for individuals with relevant clinical findings suggestive of heavy metal toxicity and a probable exposure history inanyof the following ..."