CurrentFidelis CarePolicy CP.FC.33

Clinical Policy: Autologous Hematopoietic Stem Cell Transplant (Pediatric)

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Medical necessity criteria for autologous hematopoietic stem cell transplant in patients younger than 18 years, specifying covered disease indications, performance status, infection/substance use/social support requirements, and related coding guidance.

Policy Summary

PayerFidelis Care

PolicyClinical Policy: Autologous Hematopoietic Stem Cell Transplant (Pediatric)

Policy CodePolicy CP.FC.33

Change TypeAnnual reviewscoding and reference updatesadded caregiver requirement

Effective DateFeb 1, 2021

Last ReviewJan 1, 2025

Next Review DateN/A

Key ActionProviders must document age (<18), disease-specific indication, performance status, therapeutic response, infection control, substance-use abstinence, and patient/caregiver understanding and social support for coverage determination.

SourceLink

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