What insurance policy changes affect code C75.5?

There are 2 tracked policy changes affecting code C75.5, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code C75.5?

Payers that have issued tracked updates for code C75.5 include: Aetna.

How do I get notified when code C75.5 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code C75.5. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for code C75.5?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

PAYER POLICY CHANGES

C75.5 Insurance Policy Changes

ICD-10 C75.5 is officially defined as "Malignant neoplasm of aortic body and other paraganglia." code C75.5 is referenced in 2 tracked payer policy changes from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code C75.5 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Only a small number of policies match this filter. Check back as coverage expands.

Aetna · Identified Aug 17, 2026Medium impact
Temozolomide (Temodar) Injection (CPB 0876, reviewed 2026-06-03)
Aetna's Clinical Policy Bulletin 0876 considers temozolomide (Temodar) injection medically necessary for brain metastases from solid tumors, metastatic or unresectable cutaneous melanoma as single agent subsequent therapy, second-line Ewing sarcoma in combination with irinotecan with or without vincristine, mycosis fungoides or Sezary syndrome with CNS involvement as single agent subsequent therapy, high-risk neuroblastoma in combination with irinotecan, dinutuximab and sargramostim or with irinotecan, naxitamab-gqgk and sargramostim, unresectable or metastatic pheochromocytoma or paraganglioma as single agent first-line therapy, relapsed or primary progressive small cell lung cancer as single agent subsequent therapy, advanced, recurrent, metastatic or inoperable uterine sarcoma as single agent subsequent therapy, and unresectable or metastatic uveal melanoma as a single agent. Aetna considers all other indications experimental, investigational or unproven, including chronic lymphocytic leukemia, diffuse large B-cell lymphoma, metastatic colorectal cancer and pituitary tumors. Continuation of therapy is considered medically necessary when there is no evidence of unacceptable toxicity or disease progression on the current regimen.
Aetna · Identified Aug 16, 2026Medium impact
RET Proto-Oncogene Testing (CPB 0319, reviewed 2026-06-08)
Aetna considers germline RET proto-oncogene testing medically necessary for members with a personal history of medullary thyroid carcinoma (familial or apparently sporadic), pheochromocytoma or paraganglioma when multiple endocrine neoplasia type 2 (MEN2) is suspected, parathyroid adenoma or hyperplasia when MEN2A is suspected, C-cell hyperplasia on pathology, or clinical features of MEN2B. Family history criteria include a first-degree blood relative with medullary thyroid carcinoma, a first-degree or second-degree blood relative with a known germline RET pathogenic variant, and a family pattern consistent with familial medullary thyroid carcinoma. Germline RET testing for all other indications, such as non-small cell lung cancer, is considered experimental, investigational, or unproven.

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Temozolomide (Temodar) Injection (CPB 0876, reviewed 2026-06-03)

RET Proto-Oncogene Testing (CPB 0319, reviewed 2026-06-08)

What insurance policy changes affect code C75.5?

Which payers have updated policy for code C75.5?

How do I get notified when code C75.5 policy changes?

Why do payers change policies for code C75.5?