Medium impact
Mitomycin Pyelocalyceal Solution (Jelmyto) (CPB 0972, reviewed 2025-08-13)
Aetna·Effective Aug 13, 2025
HCPCS C9789 is officially defined as "Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed." HCPCS C9789 is referenced in 1 tracked payer policy change from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS C9789 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
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