Vascularized Composite Allograft (VCA) Transplant - (0560)

Cigna considers vascularized composite allograft (VCA) transplantation experimental, investigational, or unproven and therefore not covered—citing limited evidence, significant lifelong risks (immunosuppression, infection, malignancy, chronic rejection), and listing specific unlisted CPT codes (21299, 21499, 22999, 26989, 55899) as non‑covered when used for VCA. Claims must use current appropriate diagnosis/procedure codes and include required documentation of medical necessity, informed consent and program capability (multidisciplinary team; rigorous psychiatric/psychological evaluation for face VCA), with uterine transplant handled under Cigna’s separate Infertility Services policy.

"Vascularized composite allograft (VCA) transplantation is considered experimental, investigational or unproven (policy statement)."

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