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Response to Comments: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin (DL39477)
A59306
Wisconsin Physicians Service Insurance Corporation (J05)
Effective: February 12, 2023
Updated: December 31, 2025
Policy Summary
This response-to-comments article concerns allogeneic hematopoietic cell transplantation for patients with primary refractory or relapsed Hodgkin lymphoma or non-Hodgkin lymphoma of B- or T-cell origin. The provided text does not include specific coverage criteria, documentation requirements, limitations, or frequency limits; review of the full LCD is required for actionable policy details.
Coverage Criteria Preview
Key requirements from the full policy
"Allogeneic hematopoietic cell transplantation (HCT) for patients with primary refractory or relapsed Hodgkin lymphoma or non-Hodgkin lymphoma of B-cell or T-cell origin."
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