External Infusion Pumps
National · Effective Jan 25, 2026
1 active Medicare policy lists J9100, and 7 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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National · Effective Jan 25, 2026
7 policies from 7 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Codes labeled “Inferred from policy title” are not listed in the policy document; Backwork attached them because the policy title names the drug.
| Policy | Effective | Status of J9100 |
|---|---|---|
| Daunorubicin AND Cytarabine Liposomal Vyxeos | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective |
|---|
| Status of J9100 |
|---|
| Daunorubicin and Cytarabine, Liposome (Vyxeos) | Sep 12, 2017 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
|---|
| Policy | Effective | Status of J9100 |
|---|---|---|
| Cigna MedOnc Master Drug List.pdf | Not recorded | Prior auth required |
| Policy | Effective | Status of J9100 |
|---|---|---|
| Daunorubicin/Cytarabine (Vyxeos); CP.PHAR.352 | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J9100 |
|---|---|---|
| Q3 - 2026 Jefferson Health Plans MedOnc Master Drug List | Not recorded | Prior auth required |
| Policy | Effective | Status of J9100 |
|---|---|---|
| Liposomal Formulation of Daunorubicin and Cytarabine (Vyxeos) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J9100 |
|---|---|---|
| Vyxeos (daunorubicin and cytarabine) liposome | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |