CommercialCoverageMedium impact
Hematopoietic Cell Transplantation for Chronic Myelogenous Leukemia (CPB 0674, reviewed 2026-10-07)
Aetna·Hematology, Oncology, Transplant Surgery·Medical Policy
We identified it
Oct 12, 2026
Summary
This is a policy review (not a change) of Aetna's Clinical Policy Bulletin 0674 on hematopoietic cell transplantation for chronic myelogenous leukemia, last reviewed on 2026-10-07. The policy maintains coverage for allogeneic HCT when patients fail tyrosine kinase inhibitors and classifies autologous HCT as experimental/investigational. No effective date for coverage changes is stated in the source.
Action Required
Verify current applicability of this policy with Aetna. The billing team should confirm: (1) whether the practice submits claims for allogeneic HCT (CPT 38205, 38230, 38240, 38242; HCPCS S2150) for CML patients who have failed tyrosine kinase inhibitors (imatinib, dasatinib, nilotinib, bosutinib, ponatinib, asciminib) without serious organ dysfunction; (2) ensure prior authorization is obtained from the transplanting institution's written eligibility criteria; (3) reject or deny claims for autologous HCT (CPT 38206, 38232, 38241) for CML as this remains classified as experimental/investigational under Aetna coverage; (4) confirm ICD-10 codes C92.10 and C92.11 are correctly linked to covered transplant procedures. This is a policy review, not a new implementation deadline.