Parathyroid Autotransplantation

POLICY NUMBER

L.7.03.400

DESCRIPTION

The parathyroid glands regulate the release of parathormone, the hormone that controls calcium and phosphorus metabolism and the processing of Vitamin D. Patients with end-stage renal disease may develop secondary hyperparathyroidism when the parathyroid glands attempt to counteract deteriorating kidney function. Persistent or recurrent hyperparathyroidism may develop following total or subtotal parathyroidectomy. Management includes both surgical and non-surgical options.

In the event that medical management of hyperparathyroidism fails and the patient undergoes total or subtotal parathyroidectomy, parathyroid autotransplantation may be performed following surgery when the viability of the parathyroid gland is questioned.

POLICY

Parathyroid autotransplantation is considered investigationalonly when done as a separate procedure.

POLICY EXCEPTIONS

None

POLICY GUIDELINES

The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.

Investigative is defined as the use of any treatment procedure, facility, equipment, drug, device, or supply not yet recognized as a generally accepted standard of good medical practice for the treatment of the condition being treated and; therefore, is not considered medically necessary. For the definition of Investigative, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. In order for equipment, devices, drugs or supplies [i.e, technologies], to be considered not investigative, the technology must have final approval from the appropriate governmental bodies, and scientific evidence must permit conclusions concerning the effect of the technology on health outcomes, and the technology must improve the net health outcome, and the technology must be as beneficial as any established alternative and the improvement must be attainable outside the testing/investigational setting.

POLICY HISTORY

5/2000: Approved by Medical Policy Advisory Committee (MPAC)

2/11/2002: Investigational definition added

5/2/2002: Type of Service and Place of Service deleted

9/1/2004: “Parathyroid autotransplantation is considered investigational only when done as a separate procedure” added based on the minutes of 5/2000 MPAC

11/18/2004: Reviewed by MPAC, no changes

12/30/2004: Code Reference section completed

3/28/2005: Code Reference section reviewed, no changes

12/31/2008: Policy reviewed, no changes

08/17/2015: Code Reference section updated for ICD-10.

06/01/2016: Policy number L.7.03.400 added. Investigative definition updated in Policy Guidelines section.

01/18/2023: Policy reviewed; no changes.

02/14/2024: Policy reviewed; no changes.

03/12/2025: Policy reviewed; no changes.

SOURCE(S)

Hayes Medical Technology Directory

CODE REFERENCE

This may not be a comprehensive list of procedure codes applicable to this policy.

Investigational Codes

CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.