C92.11 Insurance Policy Changes

ICD-10 C92.11 is officially defined as "Chronic myeloid leukemia, BCR/ABL-positive, in remission." code C92.11 is referenced in 3 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 C92.11 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Aetna · Identified Oct 12, 2026Medium impact
Hematopoietic Cell Transplantation for Chronic Myelogenous Leukemia (CPB 0674, reviewed 2026-10-07)
Aetna's Clinical Policy Bulletin 0674 considers allogeneic hematopoietic cell transplantation medically necessary for chronic myelogenous leukemia (CML) when the member meets the transplanting institution's written eligibility criteria. Without such criteria, allogeneic transplantation is medically necessary for members with CML who have failed to respond to, developed resistance to, or are intolerant to tyrosine kinase inhibitors (imatinib, dasatinib, nilotinib, bosutinib, ponatinib, asciminib), for persons without serious organ dysfunction based on the transplanting institution's evaluation. Aetna considers autologous transplantation (auto BM/PSCT) experimental, investigational or unproven for CML under all circumstances because its effectiveness for this indication has not been established.
Aetna · Identified Aug 17, 2026Medium impact
Hematopoietic Cell Transplantation for Chronic Myelogenous Leukemia (CPB 0674, reviewed 2025-12-23)
Aetna considers allogeneic hematopoietic cell transplantation medically necessary for chronic myelogenous leukemia when the member meets the transplanting institution's written eligibility criteria. Without such criteria, it is medically necessary for members who have failed to respond to, developed resistance to, or are intolerant to tyrosine kinase inhibitors (imatinib, dasatinib, nilotinib, bosutinib, ponatinib, asciminib), for persons without serious organ dysfunction based on the transplanting institution's evaluation. Autologous hematopoietic cell transplantation is considered experimental, investigational, or unproven for chronic myelogenous leukemia under all circumstances.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia
Allogeneic hematopoietic cell transplantation using a myeloablative conditioning regimen may be considered medically necessary as a treatment of chronic myeloid leukemia. Allogeneic hematopoietic cell transplantation using a reduced-intensity conditioning regimen may be considered medically necessary for individuals who meet clinical criteria for an allogeneic HCT but are not considered candidates for a myeloablative conditioning allogeneic HCT, and autologous HCT is investigational for chronic myeloid leukemia. The policy was reviewed 07/27/2026 with policy statements unchanged, and ICD-9 procedure and diagnosis codes were removed from the code reference.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code C92.11?

There are 3 tracked policy changes affecting code C92.11, 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 C92.11?

Payers that have issued tracked updates for code C92.11 include: Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code C92.11 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code C92.11. 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 C92.11?

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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Hematopoietic Cell Transplantation for Chronic Myelogenous Leukemia (CPB 0674, reviewed 2026-10-07)

Hematopoietic Cell Transplantation for Chronic Myelogenous Leukemia (CPB 0674, reviewed 2025-12-23)

Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia

What insurance policy changes affect code C92.11?

Which payers have updated policy for code C92.11?

How do I get notified when code C92.11 policy changes?

Why do payers change policies for code C92.11?