C84.19 coverage policies: Medicare and commercial payers

92 active Medicare policies list C84.19, and 4 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.

Get free alerts for C84.19

Free account. Policy pages stay open to everyone.

Medicare policies listing C84.19

LCD · NGS-J6-L39513

Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin and Non-Hodgkin Lymphoma with B-cell or T-cell Origin

J6 · Effective Aug 1, 2023

LCD · NGS-JK-L39513

Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin and Non-Hodgkin Lymphoma with B-cell or T-cell Origin

JK · Effective Aug 1, 2023

LCD · CGS-J15-L39434

Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin

J15 · Effective Feb 19, 2023

LCD · NORIDIAN-JE-L39396

Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin

JE · Effective Mar 5, 2023

LCD · NORIDIAN-JF-L39396

Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin

JF · Effective Mar 5, 2023

LCD · PALMETTO-JJ-L39270

Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin

JJ · Effective Sep 4, 2022

LCD · PALMETTO-JM-L39270

Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin's and Non-Hodgkin's Lymphoma with B-cell or T-cell Origin

JM · Effective Sep 4, 2022

LCD · WPS-J5-L39477

Commercial payer policies listing C84.19

4 policies from 2 payers

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

Aetna

Aetna policies listing C84.19, with the code’s status in each
Policy	Effective	Status of C84.19
Extracorporeal Photochemotherapy (Photopheresis)PayerPolicy · AETNA-CPB-0241	Mar 29, 2023	Covered
Pharmacogenetic and Pharmacodynamic TestingPayerPolicy · AETNA-CPB-0715	Feb 27, 2024	Covered
Tumor MarkersPayerPolicy · AETNA-CPB-0352	Mar 5, 2024	Covered

Ambetter

Ambetter policies listing C84.19, with the code’s status in each
Policy	Effective	Status of C84.19
Laser Therapy for Skin ConditionsPayerPolicy · AMBETTER-CP-MP-123	Not recorded	Covered