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AetnaAll Plans · Coverage · Medical Policy · OncologyMedium impact

Cancer Vaccines (CPB 0557, reviewed 2025-12-02)

Effective date
Not stated in the notice
Identified
Aug 12, 2026

Summary

Cancer vaccines are considered experimental, investigational, or unproven because their safety and effectiveness have not been established. The listed items are the helper multi-peptide (6MHP) vaccine for metastatic melanoma, HLA-A24-binding peptide vaccines for gastric cancer, the melanoma vaccine (also known as Theraccine or Oncophage) for any indication, the p16(INK4a)-based peptide vaccine for human papillomavirus-associated cancers, the p62 DNA vaccine (Elenagen) for solid tumors, and whole cancer stem cell-based vaccines used as an adjuvant strategy for the surgical management of solid tumors. The clinical evidence is stated as not sufficient to permit conclusions on health outcome effects of tumor-associated antigenic peptide-based vaccine therapy for acute myeloid leukemia, breast cancer, central nervous system cancers, colorectal cancer, gallbladder cancer, gastric cancer, glioma, head and neck cancer, hepatic cancer, lung cancer, oral squamous cell carcinoma, ovarian cancer and pancreatic cancer.

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What to do

Action · 3 steps
01Stop billing the listed cancer vaccines for the listed indications, because CPT codes are not covered for those indications.
02There is no specific CPT code for the melanoma vaccine, cancer vaccine therapy, 6MHP vaccine, or tumor-associated antigenic peptide-based vaccines.
03ICD-10 codes C00.0 through C96.9, D00.00 through D09.9 and Z23 are listed as not covered for the indications in the policy.

Codes mentioned

C00.0C96.9D00.00D09.9Z23

Original notice

Cancer Vaccines (CPB 0557, reviewed 2025-12-02)
aetna.com · Always check the source before changing claims.
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