Liver Transplants

90.4 - Liver Transplants (Rev. 2513, Issued: 08-03-12, Effective: 06-21-12, Implementation: 09-04-12) A. Background For Medicare coverage purposes, liver transplants are considered medically reasonable and necessary for specified conditions when performed in facilities that meet specific criteria. Coverage guidelines may be found in Publication 100-03, Section 260.1. Effective for claims with dates of service June 21, 2012 and later, contractors may, at their discretion cover adult liver transplantation for patients with extrahepatic unresectable cholangiocarcinoma (CCA), (2) liver metastases due to a neuroendocrine tumor (NET) or (3) hemangioendothelimo (HAE) when furnished in an approved Liver Transplant Center (below). All other nationally non-covered malignancies continue to remain nationally non- covered. To review the current list of approved Liver Transplant Centers, see http://www.cms.gov/Medicare/Provider-Enrollment-and- Certification/CertificationandComplianc/Transplant.html