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CommercialCoverageMedium impact

Ziv-Aflibercept (Zaltrap) (CPB 0842, reviewed 2025-12-09)

Aetna·Oncology, Ophthalmology, Endocrinology·Medical Policy
Effective date
Not stated
We identified it
Aug 19, 2026
Days to comply

Summary

Aetna's updated Ziv-Aflibercept (Zaltrap) policy clarifies coverage is limited to advanced or metastatic colorectal cancer (including anal and appendiceal adenocarcinoma) in combination with FOLFIRI or irinotecan. All other indications—including breast cancer, lung cancer, ovarian cancer, pancreatic cancer, and numerous others—remain experimental/investigational and are not covered. This policy maintains existing restrictions with no new coverage expansions.

Action Required

Action needed
IMMEDIATELY: Billing team must implement claim review procedures to ensure Zaltrap (J9400) claims are submitted ONLY for advanced or metastatic colorectal cancer (ICD-10: C18.0-C18.9, C19, C20, C21.0-C21.8), anal adenocarcinoma, or appendiceal adenocarcinoma. REJECT or DENY any Zaltrap claims for all other cancer types (breast, lung, ovarian, pancreatic, melanoma, lymphoma, leukemia, renal cell, prostate, bladder, thyroid, glioblastoma, sarcomas) and non-cancer indications (diabetic macular edema, age-related macular degeneration, retinal/chorioretinal conditions). Update billing system edits to flag Zaltrap claims with non-covered ICD-10 codes. Verify prior authorization is obtained for all covered CRC indications before claim submission. Notify oncology providers that off-label uses are not covered. Any claims submitted for experimental/investigational indications will be denied by Aetna.

Affected Billing Codes

96401
96402
96403
96404
96405
96406
96407
96408
96409
96410
96411
96412
96413
96414
96415
96416
96417
96418
96419
96420
96421
96422
96423
96424
96425
96426
96427
96428
96429
96430
96431
96432
96433
96434
96435
96436
96437
96438
96439
96440
96441
96442
96443
96444
96445
96446
96447
96448
96449
96450
J9400
J0640
J0641
J8521
J9035
J9190
J9206
J9263
J9271
Q0083
Q0084
Q0085
Q5107
C18.0
C18.1
C18.2
C18.3
C18.4
C18.5
C18.6
C18.7
C18.8
C18.9
C19
C20
C21.0
C21.1
C21.2
C21.8