What insurance policy changes affect code C43.31?

There are 3 tracked policy changes affecting code C43.31, including updates from Independence Blue Cross. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code C43.31?

Payers that have issued tracked updates for code C43.31 include: Independence Blue Cross.

How do I get notified when code C43.31 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code C43.31. 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 C43.31?

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.

PAYER POLICY CHANGES

C43.31 Insurance Policy Changes

ICD-10 C43.31 is officially defined as "Malignant melanoma of nose." code C43.31 is referenced in 3 tracked payer policy changes from Independence Blue Cross. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code C43.31 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Independence Blue Cross · Effective Mar 30, 2026High impact
MA11.099f, Dermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and Septorhinoplasty
Independence Blue Cross updated policy MA11.099f effective 03/30/2026, removing the strict 4-week conservative medical trial and 75% nasal obstruction documentation requirements for septoplasty and rhinoplasty/septorhinoplasty. Septoplasty now requires only documentation of an attempted medical trial (not a specific 4-week duration), and rhinoplasty/septorhinoplasty criteria were expanded to include congenital deformities as a standalone criterion. Additionally, 16 ICD-10 codes were removed and 4 new codes were added per CMS LCD A56587 updates.
Independence Blue Cross · Effective Mar 30, 2026High impact
MA11.099f, Dermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and Septorhinoplasty
Independence Blue Cross MA11.099f has been reissued with significant coverage criteria changes for septoplasty, rhinoplasty, and septorhinoplasty. Key changes include: (1) Removal of the 4-week conservative medical trial and 75% nasal obstruction threshold requirements for septoplasty—now requiring only documentation of an attempted medical trial; (2) Addition of congenital deformities as a standalone coverage criterion for rhinoplasty/septorhinoplasty; (3) Removal of 15 ICD-10 diagnosis codes and addition of 4 new codes (C4A.31, C4A.39, Z85.820, Z85.821, Z85.828) effective 03/16/2026 per CMS LCA A56587 update. These changes reduce documentation burden and expand coverage eligibility.
Independence Blue Cross · Identified Jun 19, 2026Low impact
MA08.172, Lifileucel (Amtagvi™)
This is a reissue with no changes to Independence Blue Cross Medicare Advantage policy MA08.172 for lifileucel (Amtagvi). The policy was reviewed and republished on 09/03/2025 to communicate the Company's continuing coverage position. No new billing requirements, codes, or coverage criteria have been modified since the original 10/21/2024 effective date.

Watch C43.31

Get one email when a payer policy names C43.31, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

Get alerts for changes like this

Save a search and get email alerts when a new policy change matches your filters: daily or weekly, your choice, on every plan.

Create a free alert How Policy Monitoring works

MA11.099f, Dermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and Septorhinoplasty

MA11.099f, Dermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and Septorhinoplasty

MA08.172, Lifileucel (Amtagvi™)

What insurance policy changes affect code C43.31?

Which payers have updated policy for code C43.31?

How do I get notified when code C43.31 policy changes?

Why do payers change policies for code C43.31?