MED.00102 Ultrafiltration in Decompensated Heart Failure

This policy addresses extracorporeal ultrafiltration (aquapheresis) for treating fluid overload in decompensated heart failure, including devices such as the Aquadex FlexFlow system. Anthem considers ultrafiltration investigational and not medically necessary for heart failure; therefore, it is not covered. This noncoverage applies even when used after diuretic failure and for both temporary and extended treatments, regardless of device or care setting.

"The use of ultrafiltration is consideredinvestigational and not medically necessaryfor the treatment of heart failure."

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