C56.9 coverage policies: Medicare and commercial payers

111 active Medicare policies list C56.9, and 17 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.

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Medicare policies listing C56.9

Showing 100 of 111

LCD · NOVITAS-JH-L35396

Biomarkers for Oncology

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35396

Biomarkers for Oncology

JL · Effective Oct 1, 2015

LCD · FIRST_COAST-L36499

BRCA1 and BRCA2 Genetic Testing

J9 · Effective Apr 11, 2016

LCD · NGS-J6-L33394

Drugs and Biologicals, Coverage of, for Label and Off-Label Uses

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33394

Drugs and Biologicals, Coverage of, for Label and Off-Label Uses

JK · Effective Oct 1, 2015

LCD · FIRST_COAST-L34912

Genetic Testing for Lynch Syndrome

J9 · Effective Oct 1, 2015

LCD · NGS-J6-L37810

Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms

J6 · Effective Apr 1, 2019

LCD · NGS-JK-L37810

Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms

JK · Effective Apr 1, 2019

LCD · NORIDIAN-JE-L34215

Lab: Flow Cytometry

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34215

Commercial payer policies listing C56.9

17 policies from 2 payers

Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.

Aetna

Showing 10 of 11 · All Aetna policies

Aetna policies listing C56.9, with the code’s status in each
Policy	Effective	Status of C56.9
Bevacizumab for Non-Ocular IndicationsPayerPolicy · AETNA-CPB-0685	Feb 20, 2024	Covered
Flow Cytometry, Ektacytometry, DNA Ploidy, and S-phase FractionPayerPolicy · AETNA-CPB-0351	Jun 5, 2023	Covered
Hematopoietic Cell Transplantation for Ovarian CancerPayerPolicy · AETNA-CPB-0635	Sep 13, 2023	Covered
Hyperthermia in Cancer TherapyPayerPolicy · AETNA-CPB-0278	Feb 9, 2024	Covered
In Vivo Analysis of Gastro-Intestinal and Urothelial LesionsPayerPolicy · AETNA-CPB-0783	Oct 17, 2023	Covered
Panitumumab (Vectibix)PayerPolicy · AETNA-CPB-0748

Policy	Effective	Status of C56.9
Cancer Antigen 125 TestingClinical Guideline · ANTHEM-CG-LAB-32	Oct 1, 2026	Covered
Cancer Antigen 19-9 TestingClinical Guideline · ANTHEM-CG-LAB-35	Oct 1, 2026	Covered
Carcinoembryonic Antigen TestingClinical Guideline · ANTHEM-CG-LAB-33	Oct 1, 2026	Covered
Hematopoietic Stem Cell Transplantation for Germ Cell TumorsPayerPolicy · ANTHEM-TRANS.00030	Jan 6, 2026	Covered
Human Chorionic Gonadotropin TestingClinical Guideline · ANTHEM-CG-LAB-27	Apr 15, 2026	Covered
Outpatient Alpha-Fetoprotein TestingClinical Guideline · ANTHEM-CG-LAB-26	Apr 15, 2026	Covered