Plasmapheresis - (0153)

Cigna covers therapeutic plasma exchange (CPT 36514) as medically necessary for the specific primary indications listed (e.g., Guillain‑Barré/AIDP, TTP, select TMAs, certain transplant desensitizations including ABO/HLA, acute NMDAR encephalitis, acute severe myasthenia gravis, hyperviscosity syndromes) and for specified adjunctive/secondary indications only after failure of conventional therapy, while deeming any indication not expressly listed as not medically necessary. Key requirements include indication‑specific clinical and lab documentation (e.g., documented failure of first‑line pharmacotherapy for adjunctive uses; triglycerides >10,000 mg/dL for hypertriglyceridemic pancreatitis; ADAMTS‑13 and sFlt‑1/PlGF testing for pregnancy‑associated TMA; relevant antibody testing for neurologic autoimmune conditions; and HLA/PRA and donor/recipient compatibility documentation for transplant desensitization), a treatment plan/consent, and follow‑up testing when TPE is used empirically.