Pancreas Transplants
NCD107
Medicare nationally covers whole-organ pancreas transplants when performed simultaneous with or after a kidney transplant, and covers pancreas-alone transplants only in limited circumstances at Medicare-approved kidney transplant centers. Coverage for pancreas-alone requires type I diabetes confirmation (autoantibody positive or fasting C-peptide ≤110% LLN with concurrent fasting glucose ≤225 mg/dL), medically-uncontrollable labile insulin-dependent diabetes with recurrent life-threatening metabolic complications requiring hospitalization, ≥12 months of intensive endocrinologist management, adequate psychosocial capacity, and overall suitability for transplantation; partial pancreas or islet cell transplants are not covered except in approved clinical trials.
"Whole-organ pancreas transplantation is covered when performed simultaneous with or after a kidney transplant."