Hematopoietic Cell Transplantation for Testicular C… | Aetna

Hematopoietic Cell Transplantation for Testicular Cancer

Aetna · PayerPolicy · AETNA-CPB-0617

Status: Active
Effective: September 11, 2023
Last reviewed by Aetna: December 3, 2025
Last checked by Backwork: August 1, 2026

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

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Codes in this policy

Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
38205	CPT	Covered
38206	CPT	Covered
38230	CPT	Covered
38240	CPT	Covered
38241	CPT	Covered
96401	CPT	Covered
96549	CPT	Covered
S2150	HCPCS	Covered
C62.00	ICD10CM	Covered
C62.92	ICD10CM	Covered
D07.69	ICD10CM	Covered