Hematopoietic Cell Transplantation for Testicular Cancer

Aetna covers autologous hematopoietic cell transplantation (including tandem autologous) for testicular cancer patients who are refractory (<50% tumor reduction), have a partial response (≥50% reduction), or who relapse after an initial course of standard‑dose chemotherapy, but considers autologous HCT as initial therapy (instead of standard‑dose chemo) and allogeneic HCT experimental/investigational and not covered. Coverage requires meeting the policy’s selection criteria (prior standard‑dose chemotherapy with the specified response/relapse status) and applies to the policy’s listed autologous CPT/HCPCS codes and ICD‑10 diagnoses (C62.*; D07.69).

"CPT/HCPCS billing that are covered if selection criteria are met: CPT 38206-38230 (Bone marrow or stem cell services/procedures (except allogenic)), CPT 38241 (Hematopoietic progenitor cell (HPC); ..."

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