C75.9 Insurance Policy Changes

ICD-10 C75.9 is officially defined as "Malignant neoplasm of endocrine gland, unspecified." code C75.9 is referenced in 4 tracked payer policy changes from Aetna and Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code C75.9 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Aug 17, 2026Medium impact
Stem Cells for Hematopoietic Cell Transplant (CPB 0190, reviewed 2026-03-27)
Aetna considers compatibility testing and short-term harvesting and storage of stem cells from close family donors medically necessary when an allogeneic bone marrow or peripheral stem cell transplant is authorized by Aetna, and considers umbilical cord blood an acceptable alternative to conventional bone marrow or peripheral stem cells for allogeneic transplant. Short-term storage of umbilical cord blood for a member with a malignancy undergoing treatment is covered when there is a match, and stem cell boosting for graft failure after an approved allogeneic transplant is covered when criteria are met. Co-transplantation of mesenchymal stromal cells, the Portomar bone marrow access device, the ELISPOT assay for predicting CMV infection risk, mesenchymal stromal cell-derived extracellular vesicles for GVHD, and umbilical cord blood transplantation using ex-vivo expansion are considered experimental, investigational or unproven.
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.
Aetna · Identified Aug 14, 2026Medium impact
Dendritic Cell Immunotherapy (CPB 0377, reviewed 2026-05-26)
Aetna considers dendritic cell immunotherapy experimental, investigational, or unproven because the peer-reviewed medical literature does not support its clinical use at this time, and there is no specific CPT or HCPCS code for it. ICD-10 codes for malignant neoplasms (leukemia, lymphoma, melanoma and solid tumors) and for melanoma in situ are listed as not covered for the indications in this bulletin. Current evidence is described as anecdotal, and randomized trials are needed to establish the appropriate antigen, adjuvant, dose, route and schedule.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Estrogen Hormone Testing: Estradiol and Estrone
Measurement of estrogen hormones is considered medically necessary to evaluate ovarian function in females with symptoms of hypoestrogenism or hyperestrogenism, to diagnose hyperestrogenism in symptomatic males, to monitor hormone replacement therapy in postmenopausal females, and to monitor antiestrogen therapy. Measurement of estrogen hormones is considered not medically necessary when performed for screening purposes in asymptomatic patients. The covered tests are total estradiol (CPT 82670), fractionated estrogens (CPT 82671), total estrogens (CPT 82672), estrone (CPT 82679), and free estradiol by direct measurement, such as equilibrium dialysis (CPT 82681).

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code C75.9?

There are 4 tracked policy changes affecting code C75.9, including updates from Aetna, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code C75.9?

Payers that have issued tracked updates for code C75.9 include: Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code C75.9 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code C75.9. 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 C75.9?

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.

All billing codes J3590 C9399 J3490 99215 99213 99202

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Stem Cells for Hematopoietic Cell Transplant (CPB 0190, reviewed 2026-03-27)

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

Dendritic Cell Immunotherapy (CPB 0377, reviewed 2026-05-26)

Estrogen Hormone Testing: Estradiol and Estrone

What insurance policy changes affect code C75.9?

Which payers have updated policy for code C75.9?

How do I get notified when code C75.9 policy changes?

Why do payers change policies for code C75.9?