C88.01 coverage policies: Medicare and commercial payers

57 active Medicare policies list C88.01, and 1 commercial payer policy lists 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 C88.01

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 · WPS-J5-L39477

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

J5 · Effective Feb 12, 2023

LCD · WPS-J8-L39477

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

J8 · Effective Feb 12, 2023

LCD · PALMETTO-JJ-L34415

CT of the Abdomen and Pelvis

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34415

CT of the Abdomen and Pelvis

JM · Effective Oct 1, 2015

LCD · CGS-J15-L34037

Flow Cytometry

J15 · Effective Oct 1, 2015

Commercial payer policies listing C88.01

1 policy from 1 payer

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

Anthem

Anthem policies listing C88.01, with the code’s status in each
Policy	Effective	Status of C88.01
Therapeutic ApheresisClinical Guideline · ANTHEM-CG-MED-68	Apr 15, 2026	Covered