Subject:

Description/Scope

This document addresses hand transplantation for individuals with an amputated hand. Hand transplantation is a type of vascularized composite allograft (VCA) allogenic transplantation involving multiple tissue types such as skin, connective tissue, blood vessels, bone, muscle and nerves. The goal of hand transplantation is functional restoration, rather than survival.

Note: Please see the following related document for additional information:

• CG-OR-PR-05 Myoelectric Upper Extremity Prosthetic Devices

Position Statement

Investigational and Not Medically Necessary:

Hand transplantation is considered investigational and not medically necessary.