AetnaAll Plans · Coverage · Medical Policy · OncologyMedium impact
Cancer Vaccines (CPB 0557, reviewed 2026-08-27)
Effective date
Not stated in the notice
Identified
Sep 29, 2026
Summary
Aetna considers several cancer vaccines experimental, investigational, or unproven because their safety and effectiveness have not been established. These include the helper multi-peptide (6MHP) vaccine for metastatic melanoma, the melanoma vaccine (also known as Theraccine or Oncophage) for any indication, HLA-A24-binding peptide vaccines for gastric cancer, the p16(INK4a)-based peptide vaccine for HPV-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. Aetna also states that the clinical evidence is not sufficient to permit conclusions on health outcomes for tumor-associated antigenic peptide-based vaccine therapy in listed cancers, including breast, colorectal, lung, ovarian and pancreatic cancer.
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01Billing team: Stop billing the experimental, investigational or unproven vaccines listed in the policy for the indications it lists.
02The CPT codes for HLA-A24-binding peptide vaccines, the p16(INK4a)-based peptide vaccine, the p62 DNA vaccine (Elenagen) and stem cell-based vaccines are not covered for the listed indications, and there is no specific CPT code for melanoma vaccines.
03ICD-10 codes C00.0 through C96.9, D00.00 through D09.9 and Z23 are not covered for the indications listed in the policy.
04Do not bill tumor-associated antigenic peptide-based vaccine therapy for the listed cancers, because the policy states the clinical evidence is not sufficient.
Codes mentioned
C00.0C96.9D00.00D09.9Z23
Original notice
Cancer Vaccines (CPB 0557, reviewed 2026-08-27)
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