Collection and Storage of Umbilical Cord Blood Stem Cells
SUR703.058
This policy covers collection, storage, and transplantation use of umbilical cord blood (UCB) stem cells—including public banking and private banking when there is a known, transplant‑eligible family member—and allogeneic hematopoietic stem cell transplantation for select genetic, hematologic, and malignant disorders. Coverage is limited to planned allogeneic transplants or identified recipients (e.g., affected sibling); routine or prophylactic private storage for unspecified future autologous use is not medically necessary, and benefits are subject to plan‑specific coverage, HLA‑matching requirements, and other listed limitations.
"Collection and storage of umbilical cord blood (UCB) stem cells when there is a planned allogeneic transplant for an identified recipient (e."
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