C43.10 Insurance Policy Changes

ICD-10 C43.10 is officially defined as "Malignant melanoma of unspecified eyelid, including canthus." code C43.10 is referenced in 6 tracked payer policy changes from Blue Cross Blue Shield of North Dakota. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code C43.10 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 Dec 10, 2026Medium impact
Pharmacy Policies Available Online
Blue Cross Blue Shield of North Dakota's pharmacy policy notice dated October 15, 2026 lists revisions to commercial prior authorization medical drug policies effective December 10, 2026, including Adzynma, Amtagvi, Benlysta IV, Berinert, Cinryze, Emrelis, Injectafer, Lutetium dotatate, Rituximab IV, Tecentriq IV, Tevimbra and Ziihera. Revisions to commercial post service claim edit medical drug policies, including Torisel and Xofigo, were effective November 1, 2026. Many of the entries update the contractor name to Wellpoint Federal and add the number of days allowed for authorization durations.
Blue Cross Blue Shield of North Dakota · Effective Oct 1, 2026High impact
Pharmacy Policies Available Online
Blue Cross Blue Shield of North Dakota's August 2026 pharmacy update covers Medicaid Expansion medical drug prior authorization policies, with new policies and coding changes effective October 1, 2026. The most important billing change is the new HCPCS codes that replace older codes, such as Q5172 for Filkri and J9362 for Yondelis, plus added diagnosis codes for several drugs; the commercial pharmacy policies were reviewed with no changes listed.
Blue Cross Blue Shield of North Dakota · Effective Jul 14, 2026High impact
Pharmacy Policy Updates
Blue Cross Blue Shield of North Dakota revised many Commercial prior authorization medical drug policies, with revisions effective July 14, 2026, including new or expanded indications for drugs such as Cosentyx, Darzalex SQ, Keytruda IV and Opdivo IV and changes to length of authorization durations. The same notice lists Commercial post service claim edit policy revisions effective June 1, 2026, and Commercial medical drug coding updates effective July 1, 2026 that add new HCPCS codes for denosumab biosimilars, Armlupeg, Starjemza, Eydenzelt and others and discontinue unclassified code J3590 for several of them.
Blue Cross Blue Shield of North Dakota · Effective Sep 9, 2026Medium impact
Pharmacy Policies Available Online
Blue Cross Blue Shield of North Dakota updated its commercial pharmacy policies, and the revisions to the commercial prior authorization medical drug policies are effective September 9, 2026. Revisions to the commercial post service claim edit medical drug policies are effective August 1, 2026. Many of the prior authorization policies now state the number of days allowed for initial and renewal authorization durations, replace specific contraindications in the Universal Criteria with general language that the member does not have any FDA contraindications, and add covered ICD-10 diagnosis codes in Appendix 1.
Blue Cross Blue Shield of North Dakota · Effective Aug 11, 2026Medium impact
Pharmacy Policy Updates
Blue Cross Blue Shield of North Dakota revised many Commercial prior authorization medical drug policies, with revisions effective August 11, 2026. Changes include new indications such as Enhertu for HER2-positive early-stage breast cancer, Bizengri for NRG1 gene fusion biliary tract cancer and Ocrevus IV for pediatric relapsing-remitting multiple sclerosis, along with new ICD-10 codes for breast, biliary and other cancers. The Portrazza policy is being retired, and Commercial post service claim edit policies had revisions effective July 1, 2026, including ICD-10 codes H25.11 and H25.12 added to Dextenza.
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.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code C43.10?

There are 6 tracked policy changes affecting code C43.10, including updates from Blue Cross Blue Shield of North Dakota. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code C43.10?

Payers that have issued tracked updates for code C43.10 include: Blue Cross Blue Shield of North Dakota.

How do I get notified when code C43.10 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code C43.10. 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 C43.10?

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 Policies Available Online

Pharmacy Policies Available Online

Pharmacy Policy Updates

Pharmacy Policies Available Online

Pharmacy Policy Updates

Pharmacy Policy Updates

What insurance policy changes affect code C43.10?

Which payers have updated policy for code C43.10?

How do I get notified when code C43.10 policy changes?

Why do payers change policies for code C43.10?