Blue Cross Blue Shield of Minnesota Medical Policy


Medical Policy:
Chelation Therapy
Effective Date:
July 1, 2019
Issued Date:
June 28, 2021
Last Revision Date:
June 2019
Annual Review:
June 2021

This policy version was replaced June 27, 2022. To find the newest version, go to, read and accept the Blue Cross Medical Policy Statement, then select “Blue Cross and Blue Shield of Minnesota Medical Policies.” This will bring up the Medical Policy search screen. Enter the policy number without the version number (last 3 digits).

Chelation therapy is an established treatment for the removal of metal toxins by converting them to a chemically inert form that can be excreted in the urine. Chelation therapy consists of the intravenous or oral administration of chelating agents that remove metal ions such as lead, aluminum, mercury, arsenic, zinc, iron, copper, and calcium from the body. Specific chelating agents are used for particular heavy metal toxicities. For example, deferoxamine is used for patients with iron toxicity and calcium-EDTA is used for patients with lead poisoning.

While chelation therapy has been used effectively in patients with heavy metal toxicities, it has also been proposed as treatment for other indications, including atherosclerosis, rheumatoid arthritis, and autism.

This policy is designed to address medical guidelines that are appropriate for the majority of individuals with a particular disease, illness, or condition. Each person's unique clinical circumstances may warrant individual consideration, based on review of applicable medical records.

Policy Position Coverage is subject to the specific terms of the member's benefit plan.

I.    Chelation therapy may be considered MEDICALLY NECESSARY AND APPROPRIATE in the treatment of ANY of the following conditions:

  • Control of ventricular arrhythmias or heart block, when associated with digitalis toxicity; OR
  • Acute or long-term lead poisoning; OR
  • Extreme conditions of metal toxicity (e.g., aluminum, mercury, arsenic, zinc, iron, copper); OR
  • Chronic iron overload (e.g., transfusional hemosiderosis or nontransfusion-dependent thalassemia); OR
  • Copper storage disease (i.e., Wilson’s disease or hepatolenticular degeneration); OR
  • Emergency treatment of hypercalcemia 

II.   Chelation therapy is considered EXPERIMENTAL/INVESTIGATIVE in the treatment of all other conditions including, but not limited to, the following: 

  • Coronary artery or peripheral vascular disease (e.g., atherosclerosis or secondary prevention of adverse cardiovascular events in patients with a history of myocardial infarction);
  • Hypercholesterolemia;
  • Multiple sclerosis; 
  • Arthritis;
  • Diabetes;
  • Scleroderma;
  • Porphyria;
  • Alzheimer’s disease;
  • All mental health disorders; 
  • All substance-related disorders; 
  • Mercury release from dental amalgams

Denial Statements

No additional statements.


Blue Cross and Blue Shield of Minnesota medical policies apply generally to all Blue Cross and Blue Plus plans and products. Benefit plans vary in coverage and some plans may not provide coverage for certain services addressed in the medical policies. When determining coverage, reference the member’s specific benefit plan, including exclusions and limitations.

Medicaid products may provide different coverage for certain services, which may be addressed in different policies. For Minnesota Health Care Program (MHCP) policies, please consult the MHCP Provider Manual website.

Medicare products may provide different coverage for certain services, which may be addressed in different policies. For Medicare National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and/or Local Coverage Articles, please consult CMS, National Government Services, or CGS websites. 

Note that services with specific coverage criteria may be reviewed retrospectively to determine if criteria are being met. Retrospective denial of claims may result if criteria are not met.

Blue Cross and Blue Shield of Minnesota reserves the right to revise, update and/or add to its medical policies at any time without notice. Codes listed on this policy are included for informational purposes only and are subject to change without notice. Inclusion or exclusion of a code does not constitute or imply member coverage or provider reimbursement. 

These guidelines are the proprietary information of Blue Cross and Blue Shield of Minnesota. Any sale, copying or dissemination of the medical policies is prohibited; however, limited copying of medical policies is permitted for individual use.


CPT® codes copyright American Medical Association® 2022. All rights reserved.

CDT codes copyright American Dental Association® 2022. All rights reserved.