Intestinal and Multivisceral Transplantation - (0288)

Cigna covers primary and repeat deceased‑donor intestinal, combined liver‑intestinal, multivisceral and full multivisceral transplants for total irreversible intestinal failure for specified indications (e.g., TPN failure/intolerance with impending liver failure or loss of central venous access, recurrent line sepsis, severe short‑bowel syndrome, pseudo‑obstruction, frequent hospitalizations, high risk of death, and listed disease-specific reasons) and excludes transplantation when absolute contraindications exist (e.g., uncontrolled infection, multiorgan failure, nonresectable malignancy, severe cardiopulmonary insufficiency, AIDS or demonstrated noncompliance; HIV is allowed only if strict criteria are met). Key requirements are documentation of irreversible intestinal failure and failure/intolerance of TPN (or indication‑specific findings), supporting labs/imaging, transplant candidacy evaluation showing no absolute contraindications (including HIV: CD4>200, undetectable HIV‑1 RNA, stable ART >3 months, no serious HIV complications), and use of appropriate diagnosis/procedure codes for claims.