TRANS.00009 Lung and Lobar Transplantation

This policy addresses lung and lobar transplantation. It is considered medically necessary for individuals who meet general transplant selection criteria and have irreversible, progressively disabling end-stage pulmonary disease, including restrictive lung diseases such as idiopathic or interstitial pulmonary fibrosis, scleroderma, sarcoidosis, extrinsic allergic alveolitis, post-chemotherapy disease, and asbestosis. Transplantation is investigational and not medically necessary for all other diagnoses; candidates must have no contraindications per AST guidelines (e.g., metastatic cancer), and multi-organ transplant requests must meet criteria for each organ with case-by-case review.

"Lung or lobar transplantation is consideredmedically necessaryfor individuals who meet the general individual selection criteriaandhave irreversible, progressively disabling, end-stage pulmonary di..."