Autologous stem cell transplantation (ASCT) is a process in which stem cells are harvested from a patient’s bone marrow or peripheral blood, stored, and then transplanted back into the patient following high dose chemotherapy use to treat various malignancies. The Coverage Issues Manuel (CIM), §35-30 does not have a policy decision in regards to coverage of ASCT for AL amyloidosis. Thus, coverage NCDs are made at contractor’s discretion. HCFA must evaluate whether there is enough scientific evidence that supports the “reasonable” and “necessary” criteria for a national coverage decision.