Transplantation of cord blood stem cells from related or unrelated donors may be considered medically necessary in patients with an appropriate indication for allogeneic stem cell transplant.
Transplantation of cord blood stem cells from related or unrelated donors is considered investigational in all other situations.
Collection and storage of cord blood from a neonate may be considered medically necessary when an allogeneic transplant is imminent in an identified recipient with a diagnosis that is consistent with the possible need for allogeneic transplant.
Prophylactic collection and storage of cord blood from a neonate may be considered not medically necessary when proposed for some unspecified future use as an autologous stem cell transplant in the original donor, or for some unspecified future use as an allogeneic stem cell transplant in a related or unrelated donor.
