D02.20 Insurance Policy Changes

ICD-10 D02.20 is officially defined as "Carcinoma in situ of unspecified bronchus and lung." code D02.20 is referenced in 5 tracked payer policy changes from Excellus BlueCross BlueShield, Aetna, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code D02.20 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Excellus BlueCross BlueShield · Effective Feb 19, 2026Medium impact
Photodynamic Therapy for Malignant Disease 8.01.06
Excellus medical policy 8.01.06 covers photodynamic therapy (PDT) for malignant disease. PDT with Photofrin is considered medically appropriate for early-stage non-small-cell lung cancer in patients who are ineligible for surgery and radiation, for completely or partially obstructing endobronchial lesions, for palliative treatment of obstructing esophageal cancer, for Barrett's high-grade dysplasia in patients at high risk during prophylactic esophagectomy who decide on this treatment through shared decision-making, and for palliative treatment of unresectable cholangiocarcinoma as an adjunct to stenting. PDT with 5-aminolevulinic acid is considered medically appropriate for superficial and nodular basal cell skin cancer and for Bowen's disease, only when surgery or radiation is contraindicated, and PDT is considered investigational for other malignancies. The current effective date is February 19, 2026, and the April 28, 2026 edit corrected grammatical errors and alphabetized reference entries.
Aetna · Identified Oct 10, 2026Medium impact
Radiofrequency Tumor Ablation (CPB 0492, reviewed 2026-10-05)
Aetna considers radiofrequency ablation (RFA) medically necessary for indications that include colorectal cancer liver metastases, colorectal cancer lung metastases of 5 cm or less where the primary colorectal tumor has been resected for cure (R0 resection), malignant lung masses in persons who are not candidates for surgical intervention, solitary hepatocellular carcinoma of 5 cm or less or multinodular early-stage HCC in members who are ineligible for or decline surgical resection or transplantation, renal cell carcinoma up to 4 cm in high-risk surgical candidates or in persons with renal insufficiency or a solitary kidney, and osteoid osteoma in individuals who remain symptomatic despite NSAIDs. Aetna considers RFA experimental, investigational, or unproven for combined RFA with transarterial chemoembolization for intermediate-stage hepatocellular carcinoma, combined endoluminal RFA and stenting for malignant biliary obstruction or stricture, combined RFA and vertebral cement augmentation for spinal metastases, endoscopic ultrasound-guided RFA for aldosterone-producing adenomas, and all other indications, including curative treatment of primary or metastatic malignant neoplasms in persons able to tolerate surgical resection, biliary obstructions or strictures, renal cysts, renal angiomyolipomas, Brunner's gland hyperplasia, and unresectable localized recurrent thyroid cancers without distant metastases.
Aetna · Identified Aug 19, 2026Medium impact
Brachytherapy (CPB 0371, reviewed 2026-05-20)
Aetna considers brachytherapy medically necessary for breast, esophageal, eye tumors, genitourinary cancers other than bladder, gynecologic, head and neck, respiratory and digestive tract, and soft tissue sarcoma indications when the EviCore Healthcare Radiation Therapy Clinical Guidelines criteria are met. It also considers brachytherapy medically necessary for skin cancer where surgical resection and photon or electron beam techniques are contraindicated, and for stenotic obstruction after lung transplantation refractory to other treatments. Brachytherapy for bladder cancer, bone metastases, brain tumors, leukemia, lymphoma, multiple myeloma, pancreatic cancer, keloids, palmoplantar pustulosis, spinal tumors and spinal metastases, and subfoveal choroidal neovascularization secondary to age-related macular degeneration is considered experimental, investigational or unproven, and electronic brachytherapy is considered experimental, investigational or unproven for breast cancer and all other indications.
Aetna · Identified Aug 18, 2026Medium impact
Lung Imaging: Selected Techniques (CPB 0581, reviewed 2026-02-24)
Aetna considers lung imaging fluorescence endoscopy (LIFE) medically necessary to enhance the physician's ability to detect and biopsy abnormal bronchial tissue suspicious for pre-cancerous lesions, carcinomas in situ, and early bronchogenic carcinomas in members with known or previously diagnosed lung cancer, members with suspected lung cancer, and members with a previously resected Stage I lung cancer who have no evidence of metastatic disease and are at risk for secondary disease. Suspected lung cancer includes positive sputum cytology, hemoptysis, infiltrates, or pneumonia signs or symptoms that do not resolve within 30 days of treatment, persistent cough, or a positive X-ray. Aetna considers computer-aided lung informatics for pathology evaluation and rating (CALIPER) for interstitial lung disease, contrast-enhanced ultrasonography for diagnosis of lung cancer, LIFE for all other indications, 3D lung CT for evaluation of bronchial anatomy, point laser Raman spectroscopy, XV LVAS pulmonary tissue ventilation analysis, and Xenon Xe-129 hyperpolarized gas (Xenoview) for lung ventilation evaluation experimental, investigational, or unproven. The CPT codes 0807T, 0808T, 0877T, 0878T, 0879T, 0880T, 76376, 76377, 76978, and 76979 and the HCPCS codes A9610 and C9791 are listed as not covered for the indications in this policy. source issue date 2026-02-24.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Oncologic Applications of Photodynamic Therapy, Including Barrett Esophagus
Photodynamic therapy may be considered medically necessary for palliative treatment of obstructing esophageal cancer, palliative treatment of obstructing endobronchial lesions, early-stage non-small-cell lung cancer in individuals ineligible for surgery and radiotherapy, high-grade dysplasia in Barrett esophagus, and palliative treatment of unresectable cholangiocarcinoma when used with stenting. Other oncologic applications, including Barrett esophagus without high-grade dysplasia, are investigational. The policy history records a 09/12/2025 description update, with policy guidelines updated regarding focal therapy.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code D02.20?

There are 5 tracked policy changes affecting code D02.20, including updates from Excellus BlueCross BlueShield, 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 D02.20?

Payers that have issued tracked updates for code D02.20 include: Excellus BlueCross BlueShield, Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code D02.20 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code D02.20. 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 D02.20?

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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Photodynamic Therapy for Malignant Disease 8.01.06

Radiofrequency Tumor Ablation (CPB 0492, reviewed 2026-10-05)

Brachytherapy (CPB 0371, reviewed 2026-05-20)

Lung Imaging: Selected Techniques (CPB 0581, reviewed 2026-02-24)

Oncologic Applications of Photodynamic Therapy, Including Barrett Esophagus

What insurance policy changes affect code D02.20?

Which payers have updated policy for code D02.20?

How do I get notified when code D02.20 policy changes?

Why do payers change policies for code D02.20?