Anthem Blue Cross Connecticut MED.00102 Ultrafiltration in Decompensated Heart Failure Form

This document addresses ultrafiltration, (also referred to as aquapheresis), a treatment for refractory congestive heart failure (CHF, also referred to as heart failure [HF]) that involves the removal of excess fluid. The technique utilizes pressure differentials during treatment with a dialysis machine or similar filtration device. Proponents suggest that this treatment may offer the potential for greater and more expeditious volume and sodium removal compared with conventional therapies for hospitalized individuals. Ultrafiltration is generally used for decompensated HF where fluid overload is unresponsive to conventional medical management with use of diuretics.

Position Statement

Investigational and Not Medically Necessary:

The use of ultrafiltration is considered investigational and not medically necessary for the treatment of heart failure.