C20 Insurance Policy Changes

ICD-10 C20 is officially defined as "Malignant neoplasm of rectum." code C20 is referenced in 26 tracked payer policy changes from Blue Cross Blue Shield of North Dakota, Aetna, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code C20 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Blue Cross Blue Shield of North Dakota · Effective Jun 10, 2026Medium impact
Pharmacy Policy Updates
Blue Cross Blue Shield of North Dakota revised many Commercial prior authorization medical drug policies, with revisions effective June 10, 2026. Most changes delineate initial and renewal authorization durations and state the number of days allowed, add the NQTL Factor Checklist appendix, and add new or expanded indications for oncology and other drugs, while the Aliqopa policy is being retired after the manufacturer withdrew the product. Separately, Commercial post service claim edit policies had revisions effective May 1, 2026.
Aetna · Identified Oct 29, 2026Medium impact
Transanal Endoscopic Microsurgery (CPB 0747, reviewed 2026-10-21)
Aetna's Clinical Policy Bulletin 0747, last reviewed 10/21/2026, covers transanal endoscopic microsurgery (TEM). Aetna considers TEM medically necessary for benign rectal tumors (adenomas), low-risk Tis and T1 rectal carcinoma, and small rectal carcinoids less than 2 cm in diameter. Aetna considers TEM experimental, investigational, or unproven for other indications, including advanced rectal cancer, anorectal melanoma, benign rectal strictures, rectal prolapse and diverticula, and megacolon. The source text does not describe what changed in this review.
Aetna · Identified Oct 15, 2026Medium impact
Avelumab (Bavencio) (CPB 0916, reviewed 2026-10-14)
Aetna considers avelumab (Bavencio) medically necessary for commercial plan members with Merkel cell carcinoma, renal cell carcinoma in combination with axitinib, urothelial carcinomas, gestational trophoblastic neoplasia, endometrial carcinoma, thymic carcinoma, extranodal NK/T-cell lymphoma, colorectal adenocarcinoma, and small bowel adenocarcinoma when the criteria for each indication are met. Precertification of avelumab is required for all Aetna participating providers and members in applicable plan designs, and members who have experienced disease progression while on PD-1 or PD-L1 inhibitor therapy are not eligible. Aetna considers avelumab experimental, investigational, or unproven for all other indications, including breast cancer, non-small cell lung cancer, ovarian cancer, prostate cancer, and pancreatic cancer.
Aetna · Identified Oct 13, 2026Medium impact
Toripalimab-tpzi (Loqtorzi) (CPB 1049, reviewed 2026-10-05)
Aetna considers toripalimab-tpzi (Loqtorzi) medically necessary for initial approval in anal carcinoma, appendiceal neoplasms and cancers, colorectal cancer, nasopharyngeal carcinoma, non-small cell lung cancer and small bowel adenocarcinoma when the criteria in the policy are met, and considers all other indications experimental, investigational, or unproven. Continuation of therapy is considered medically necessary for up to 24 months total in nasopharyngeal carcinoma and non-small cell lung cancer, and for up to 13 cycles total for neoadjuvant NSCLC, when there is no evidence of unacceptable toxicity or disease progression. Precertification of Loqtorzi is required of all Aetna participating providers and members in applicable plan designs.
Aetna · Identified Oct 10, 2026Medium impact
Radiofrequency Tumor Ablation (CPB 0492, reviewed 2026-10-05)
Aetna considers radiofrequency ablation (RFA) medically necessary for indications that include colorectal cancer liver metastases, colorectal cancer lung metastases of 5 cm or less where the primary colorectal tumor has been resected for cure (R0 resection), malignant lung masses in persons who are not candidates for surgical intervention, solitary hepatocellular carcinoma of 5 cm or less or multinodular early-stage HCC in members who are ineligible for or decline surgical resection or transplantation, renal cell carcinoma up to 4 cm in high-risk surgical candidates or in persons with renal insufficiency or a solitary kidney, and osteoid osteoma in individuals who remain symptomatic despite NSAIDs. Aetna considers RFA experimental, investigational, or unproven for combined RFA with transarterial chemoembolization for intermediate-stage hepatocellular carcinoma, combined endoluminal RFA and stenting for malignant biliary obstruction or stricture, combined RFA and vertebral cement augmentation for spinal metastases, endoscopic ultrasound-guided RFA for aldosterone-producing adenomas, and all other indications, including curative treatment of primary or metastatic malignant neoplasms in persons able to tolerate surgical resection, biliary obstructions or strictures, renal cysts, renal angiomyolipomas, Brunner's gland hyperplasia, and unresectable localized recurrent thyroid cancers without distant metastases.
Aetna · Identified Aug 19, 2026Medium impact
Brachytherapy (CPB 0371, reviewed 2026-05-20)
Aetna considers brachytherapy medically necessary for breast, esophageal, eye tumors, genitourinary cancers other than bladder, gynecologic, head and neck, respiratory and digestive tract, and soft tissue sarcoma indications when the EviCore Healthcare Radiation Therapy Clinical Guidelines criteria are met. It also considers brachytherapy medically necessary for skin cancer where surgical resection and photon or electron beam techniques are contraindicated, and for stenotic obstruction after lung transplantation refractory to other treatments. Brachytherapy for bladder cancer, bone metastases, brain tumors, leukemia, lymphoma, multiple myeloma, pancreatic cancer, keloids, palmoplantar pustulosis, spinal tumors and spinal metastases, and subfoveal choroidal neovascularization secondary to age-related macular degeneration is considered experimental, investigational or unproven, and electronic brachytherapy is considered experimental, investigational or unproven for breast cancer and all other indications.
Aetna · Identified Aug 19, 2026Medium impact
Ziv-Aflibercept (Zaltrap) (CPB 0842, reviewed 2025-12-09)
Ziv-aflibercept (Zaltrap) is considered medically necessary for advanced or metastatic colorectal cancer, including anal adenocarcinoma and appendiceal adenocarcinoma, in combination with FOLFIRI or in combination with irinotecan. Continuation of therapy is considered medically necessary for these indications when there is no evidence of unacceptable toxicity or disease progression while on the current regimen. All other indications, including combination with bevacizumab and ziv-aflibercept plus pembrolizumab for solid tumors, are considered experimental, investigational, or unproven.
Aetna · Identified Aug 18, 2026Medium impact
Trastuzumab Products (CPB 0313, reviewed 2026-06-08)
Aetna Clinical Policy Bulletin 0313 sets coverage rules for trastuzumab products for commercial medical plans, including Herceptin and the biosimilars Hercessi, Herzuma, Kanjinti, Ogivri, Ontruzant and Trazimera. Aetna considers these products medically necessary for HER2-positive breast cancer in the adjuvant, neoadjuvant and metastatic settings, for HER2-positive esophageal, gastric, biliary, salivary gland, small bowel, appendiceal and uterine serous cancers, and for HER2-positive, RAS and BRAF wild-type colorectal cancer when the listed criteria are met. Aetna considers all other indications experimental, investigational or unproven, including lung, ovarian, pancreatic, prostate, bladder and melanoma, and considers lapatinib plus trastuzumab and pertuzumab plus trastuzumab for HER2-positive breast cancer experimental, investigational or unproven.
Aetna · Identified Aug 18, 2026Medium impact
Transanal Endoscopic Microsurgery (CPB 0747, reviewed 2025-11-26)
Aetna covers transanal endoscopic microsurgery (TEM) for benign rectal tumors (adenomas), low-risk Tis and T1 rectal carcinoma, and small rectal carcinoids less than 2 cm in diameter. Aetna considers TEM experimental, investigational, or unproven for other indications, including advanced rectal cancer, anorectal melanoma, benign rectal strictures, rectal prolapse and diverticula, rectal schwannoma, and recto-urinary and recto-vesical fistulas. The covered CPT code is 0184T, and the policy lists the ICD-10 codes that are covered if selection criteria are met and the codes not covered for the listed indications.
Aetna · Identified Aug 18, 2026Medium impact
Toripalimab-tpzi (Loqtorzi) (CPB 1049, reviewed 2026-08-10)
Aetna's Clinical Policy Bulletin 1049 covers toripalimab-tpzi (Loqtorzi) for commercial medical plans, and Medicare criteria are in a separate Medicare Part B policy. Precertification of Loqtorzi is required of Aetna participating providers and members in applicable plan designs, and the Site of Care Utilization Management Policy applies. Aetna considers the drug medically necessary for initial approval in anal carcinoma, appendiceal neoplasms and cancers, colorectal cancer, nasopharyngeal carcinoma, non-small cell lung cancer, and small bowel adenocarcinoma, each under the criteria listed for that indication, and considers all other indications experimental, investigational, or unproven. Members are not eligible when they have experienced disease progression while on PD-1 or PD-L1 inhibitor therapy. Continuation of therapy is considered medically necessary for up to 24 months total for nasopharyngeal carcinoma first-line therapy and for NSCLC, for up to 13 cycles total for neoadjuvant NSCLC, and for other listed indications when there is no evidence of unacceptable toxicity or disease progression.
Aetna · Identified Aug 18, 2026Medium impact
Tislelizumab-jsgr (Tevimbra) (CPB 1057, reviewed 2025-12-05)
Aetna Clinical Policy Bulletin 1057 sets the commercial medical coverage criteria for tislelizumab-jsgr (Tevimbra). Aetna considers it medically necessary for several cancers under indication-specific criteria, including subsequent treatment of metastatic anal carcinoma, esophageal and esophagogastric junction cancer, HER2-negative gastric adenocarcinoma, metastatic nasopharyngeal cancer, hepatocellular carcinoma, and histologic (Richter) transformation to diffuse large B-cell lymphoma. It also covers MSI-H, dMMR, or POLE/POLD1 ultra-hypermutated small bowel, colon, appendiceal, and rectal adenocarcinomas under the stated criteria, and considers all other indications experimental, investigational, or unproven.
Aetna · Identified Aug 17, 2026Medium impact
Ado-trastuzumab Emtansine (Kadcyla) (CPB 0974, reviewed 2026-01-21)
Aetna covers ado-trastuzumab emtansine (Kadcyla) for commercial medical plans and requires precertification for it. Covered uses include HER2-positive breast cancer in the settings listed in the policy, non-small cell lung cancer with HER2 (ERBB2) mutations when the drug is used as a single agent and the member has not progressed on a HER2 targeted drug such as Enhertu, and recurrent, unresectable or metastatic HER2-positive salivary gland tumors. Aetna considers all other indications experimental, investigational, or unproven, including use together with Herceptin, Tykerb or Perjeta, HER2-negative breast cancer, gastric cancer, colorectal cancer and hepatobiliary cancers.
Aetna · Identified Aug 17, 2026Medium impact
ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP) (CPB 0780, reviewed 2026-04-27)
Aetna considers the ADAMTS13 assay medically necessary for assessing prognosis in persons with thrombotic thrombocytopenic purpura (TTP), and for distinguishing hematopoietic stem cell transplant-associated thrombotic microangiopathy (HSCT-TMA, also called transplant-associated TMA) from TTP in persons with overlapping features when the test will be used to inform treatment. Aetna considers the assay experimental, investigational, or unproven for the uses it lists because of insufficient evidence, including sepsis-associated thrombotic microangiopathy, hemolytic uremic syndrome, acute myelogenous leukemia, colorectal cancer survival, COVID-19, cerebral infarction, and ADAMTS13 mutation testing for non-cirrhotic portal hypertension.
Aetna · Identified Aug 16, 2026Medium impact
Fibroid Treatment (CPB 0304, reviewed 2026-04-17)
Aetna considers radiofrequency ablation or transcatheter uterine artery embolization medically necessary as an alternative to hysterectomy or myomectomy for uterine fibroids when the member has persistent symptoms directly attributed to the fibroids, such as excessive menstrual bleeding, bulk-related pelvic pain, pressure or discomfort, urinary symptoms from compression of the ureter or bladder, or dyspareunia. Aetna considers myomectomy or hysterectomy using power morcellation experimental, investigational, or unproven, except in women without known or strongly suspected uterine cancer who meet the listed exception criteria, such as premenopausal women who wish to maintain fertility and have no risk factors for uterine sarcoma. Aetna also considers cryomyolysis, cryotherapy, electrical ablation, interstitial thermotherapy, laparoscopic uterine artery occlusion, lasers, focused ultrasound ablation, acupuncture, and other uses of transcatheter uterine artery embolization experimental, investigational, or unproven.
Aetna · Identified Aug 16, 2026Medium impact
Levoleucovorin (Khapzory) (CPB 0889, reviewed 2025-12-04)
Aetna Clinical Policy Bulletin 0889 covers levoleucovorin (Khapzory) for commercial medical plans, and Medicare criteria are in a separate document. Aetna considers Khapzory more costly than other levoleucovorin products and considers it medically necessary only for members with a contraindication, intolerance or ineffective response to the generic levoleucovorin equivalents, when leucovorin is not an available or appropriate option. Generic or Khapzory levoleucovorin is considered medically necessary for rescue treatment after high-dose methotrexate therapy, treatment of a folate antagonist overdose or impaired methotrexate elimination, or combination therapy with fluorouracil-based chemotherapy regimens, under the same leucovorin condition. Continuation of therapy is considered medically necessary for all members, including new members, who meet the initial criteria. The brand Fusilev has been discontinued by the manufacturer.
Aetna · Identified Aug 16, 2026Medium impact
Retifanlimab-dlwr (Zynyz) (CPB 1030, reviewed 2026-04-27)
Aetna considers retifanlimab-dlwr (Zynyz) medically necessary for commercial medical plans in these indications: Merkel cell carcinoma as a single agent; squamous cell carcinoma of the anal canal (SCAC) in combination with carboplatin and paclitaxel, or as a single agent after progression on or intolerance to platinum-based chemotherapy; dMMR/MSI-H or POLE/POLD1 ultra-hypermutated colorectal cancer, small bowel adenocarcinoma, and appendiceal neoplasms and cancers, each as a single agent. Aetna considers all other indications experimental, investigational, or unproven, and considers members not eligible when they have experienced disease progression while on PD-1 or PD-L1 inhibitor therapy. Continuation is considered medically necessary for up to 12 months with carboplatin and paclitaxel or up to 24 months as a single agent for SCAC, and up to 24 months for the other listed indications, when there is no evidence of unacceptable toxicity or disease progression on the current regimen.
Aetna · Identified Aug 15, 2026Medium impact
Ipilimumab (Yervoy) (CPB 0815, reviewed 2026-07-16)
Aetna's Clinical Policy Bulletin 0815 covers ipilimumab (Yervoy) for commercial medical plans. It considers ipilimumab medically necessary for the cancer indications listed in the policy, many of them in combination with nivolumab, and considers continued treatment medically necessary for members requesting reauthorization when there is no evidence of unacceptable toxicity or disease progression. It considers ipilimumab experimental, investigational, or unproven for indications such as glioblastoma, pancreatic cancer, and prostate cancer, and for use with bevacizumab, vemurafenib, dabrafenib, or trametinib.
Aetna · Identified Aug 13, 2026Medium impact
Pemetrexed Products (CPB 0687, reviewed 2026-07-17)
Aetna considers pemetrexed (Alimta, Axtle, Pemfexy, Pemrydi RTU, or generic pemetrexed) medically necessary for commercial members with the listed indications: non-squamous non-small cell lung cancer, pleural and peritoneal mesothelioma, ovarian, fallopian tube and primary peritoneal cancer, cervical cancer, bladder cancer, primary CNS lymphoma, thymoma and thymic carcinoma, thyroid cancer, and vaginal cancer. Members with squamous cell non-small cell lung cancer are not eligible, and indications such as breast, colorectal, gastric, pancreatic and small cell lung cancer are experimental, investigational, or unproven. Continuation is covered when there is no unacceptable toxicity or disease progression, and use with pembrolizumab for pleural or peritoneal mesothelioma is covered for up to 24 months total.
Aetna · Identified Aug 13, 2026Medium impact
Durvalumab (Imfinzi) (CPB 0917, reviewed 2026-06-25)
Aetna considers durvalumab (Imfinzi) medically necessary for commercial medical plans when the criteria for a listed indication are met, and considers all other indications experimental, investigational, or unproven. Precertification is required of all Aetna participating providers and members in applicable plan designs, and Aetna considers members not eligible for Imfinzi when they have experienced disease progression while on PD-1 or PD-L1 inhibitor therapy. Continuation of therapy is medically necessary when there is no evidence of unacceptable toxicity or disease progression on the current regimen, up to 12 months total for unresectable stage II or III NSCLC and up to 24 months total for limited stage SCLC.
Aetna · Identified Aug 12, 2026Medium impact
Cemiplimab-rwlc (Libtayo) (CPB 0942, reviewed 2026-06-12)
Aetna's Clinical Policy Bulletin 0942 sets the commercial coverage criteria for cemiplimab-rwlc (Libtayo). Aetna considers Libtayo medically necessary for cutaneous squamous cell carcinoma, basal cell carcinoma, non-small cell lung cancer, and the vulvar, cervical, vaginal, anal, small bowel, colon, appendiceal and rectal cancers listed in the policy when the stated criteria are met. Aetna considers all other indications experimental, investigational, or unproven, including hepatocellular carcinoma, Merkel cell carcinoma, penile cancer, Marjolin ulcer and xeroderma pigmentosum.
Aetna · Identified Aug 12, 2026Medium impact
Avelumab (Bavencio) (CPB 0916, reviewed 2025-10-09)
Aetna's criteria cover avelumab (Bavencio) for Merkel cell carcinoma as a single agent; first-line advanced renal cell carcinoma with clear cell histology in combination with axitinib; urothelial carcinomas (bladder cancer, primary carcinoma of the urethra, upper genitourinary tract tumors, and urothelial carcinoma of the prostate) as subsequent therapy or as maintenance therapy when there is no progression on first-line platinum-containing chemotherapy; gestational trophoblastic neoplasia; recurrent endometrial carcinoma (as a single agent when MSI-H or dMMR, or with axitinib when pMMR); thymic carcinoma with axitinib; relapsed or refractory extranodal NK/T-cell lymphoma; and colorectal or small bowel adenocarcinoma that is dMMR/MSI-H or POLE/POLD1 ultra-hypermutated, as a single agent or as neoadjuvant treatment of up to 6 months. Members who have experienced disease progression while on PD-1 or PD-L1 inhibitor therapy are not eligible, and all other indications are considered experimental, investigational or unproven. This policy addresses avelumab for commercial medical plans, where precertification is required and the Site of Care Utilization Management Policy applies.
Aetna · Identified Aug 12, 2026Medium impact
Atezolizumab (Tecentriq) and Atezolizumab and Hyaluronidase-tqjs (Tecentriq Hybreza) (CPB 0909, reviewed 2026-06-30)
Aetna's commercial coverage policy for atezolizumab (Tecentriq) and atezolizumab and hyaluronidase-tqjs (Tecentriq Hybreza) covers them for specific indications when the criteria are met. Covered indications include recurrent, advanced or metastatic non-small cell lung cancer, extensive-stage small cell lung cancer, hepatocellular carcinoma in combination with bevacizumab, BRAF V600 mutation-positive melanoma in combination with cobimetinib and vemurafenib, alveolar soft part sarcoma, and adjuvant treatment of muscle invasive bladder cancer after cystectomy when the member is positive for circulating tumor DNA molecular residual disease. Precertification is required in applicable plan designs, and the Site of Care Utilization Management Policy applies. Use for all other indications is considered experimental, investigational, or unproven, and members are not eligible after disease progression on PD-1 or PD-L1 inhibitor therapy.
Aetna · Identified Aug 12, 2026Medium impact
Ablation of Hepatic Lesions (CPB 0274, reviewed 2026-06-08)
Aetna considers cryosurgery, microwave, or conventional tumor-puncture nonpulsed radiofrequency ablation of liver tumors medically necessary for members with isolated colorectal cancer liver metastases or isolated hepatocellular cancer who are not candidates for open surgical resection, when all selection criteria are met. The criteria require that all liver tumors seen on pre-operative imaging would be potentially destroyed by the ablation, and that liver lesions be 4 cm or less in diameter and occupy less than 50% of the liver parenchyma. Aetna considers these ablation methods experimental, investigational, or unproven when the criteria are not met, and lists histotripsy, no-touch radiofrequency ablation, percutaneous irreversible electroporation for inoperable colorectal liver metastases, microwave ablation of hepatic adenoma and hemangioma, and percutaneous thermal segmentectomy as experimental, investigational, or unproven.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Intraoperative Radiotherapy
Intraoperative radiotherapy (IORT) may be considered medically necessary only for rectal cancer with positive or close margins with T4 lesions or recurrent disease. IORT is considered investigational for all other oncologic applications. This policy does not address the use of IORT for breast cancer, which is addressed in the related policy Accelerated Breast Irradiation and Brachytherapy Boost After Breast-Conserving Surgery for Early Stage Breast Cancer.
Aetna · Identified Oct 17, 2026Low impact
Electrical Stimulation for Nausea, Vomiting, Motion Sickness and Other Selected Indications (CPB 0676, reviewed 2026-10-07)
Aetna clinical policy bulletin 0676 (reviewed October 7, 2026) covers prescription ReliefBand and PrimaBella devices for post-operative or chemotherapy-induced nausea that does not respond to antiemetics and conservative care, and for hyperemesis gravidarum that does not respond to conservative therapy. It treats other transcutaneous acupoint stimulation uses, such as motion sickness, autism, dysmenorrhea and fertility, as experimental, and does not cover over-the-counter disposable ReliefBand devices. The source gives a review date but no effective date.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Low impact
Transanal Endoscopic Microsurgery
Transanal endoscopic microsurgery may be considered medically necessary for treatment of rectal adenomas, including recurrent adenomas, that cannot be removed using other means of local excision. It may also be considered medically necessary for clinical stage T1 rectal adenocarcinomas that cannot be removed using other means of local excision and that meet all listed criteria. Transanal endoscopic microsurgery is investigational for rectal tumors that do not meet those criteria. The 05/19/2026 review left the policy statements unchanged and removed ICD-9 procedure and diagnosis codes from the code reference.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code C20?

There are 26 tracked policy changes affecting code C20, including updates from Blue Cross Blue Shield of North Dakota, Aetna, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code C20?

Payers that have issued tracked updates for code C20 include: Blue Cross Blue Shield of North Dakota, Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code C20 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code C20. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for code C20?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

All billing codes J3590 C9399 J3490 99215 99213 99202

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Pharmacy Policy Updates

Transanal Endoscopic Microsurgery (CPB 0747, reviewed 2026-10-21)

Avelumab (Bavencio) (CPB 0916, reviewed 2026-10-14)

Toripalimab-tpzi (Loqtorzi) (CPB 1049, reviewed 2026-10-05)

Radiofrequency Tumor Ablation (CPB 0492, reviewed 2026-10-05)

Brachytherapy (CPB 0371, reviewed 2026-05-20)

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

Trastuzumab Products (CPB 0313, reviewed 2026-06-08)

Transanal Endoscopic Microsurgery (CPB 0747, reviewed 2025-11-26)

Toripalimab-tpzi (Loqtorzi) (CPB 1049, reviewed 2026-08-10)

Tislelizumab-jsgr (Tevimbra) (CPB 1057, reviewed 2025-12-05)

Ado-trastuzumab Emtansine (Kadcyla) (CPB 0974, reviewed 2026-01-21)

ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP) (CPB 0780, reviewed 2026-04-27)

Fibroid Treatment (CPB 0304, reviewed 2026-04-17)

Levoleucovorin (Khapzory) (CPB 0889, reviewed 2025-12-04)

Retifanlimab-dlwr (Zynyz) (CPB 1030, reviewed 2026-04-27)

Ipilimumab (Yervoy) (CPB 0815, reviewed 2026-07-16)

Pemetrexed Products (CPB 0687, reviewed 2026-07-17)

Durvalumab (Imfinzi) (CPB 0917, reviewed 2026-06-25)

Cemiplimab-rwlc (Libtayo) (CPB 0942, reviewed 2026-06-12)

Avelumab (Bavencio) (CPB 0916, reviewed 2025-10-09)

Atezolizumab (Tecentriq) and Atezolizumab and Hyaluronidase-tqjs (Tecentriq Hybreza) (CPB 0909, reviewed 2026-06-30)

Ablation of Hepatic Lesions (CPB 0274, reviewed 2026-06-08)

Intraoperative Radiotherapy

Electrical Stimulation for Nausea, Vomiting, Motion Sickness and Other Selected Indications (CPB 0676, reviewed 2026-10-07)

Transanal Endoscopic Microsurgery

What insurance policy changes affect code C20?

Which payers have updated policy for code C20?

How do I get notified when code C20 policy changes?

Why do payers change policies for code C20?