What insurance policy changes affect code C50.A01?

There are 8 tracked policy changes affecting code C50.A01, 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 C50.A01?

Payers that have issued tracked updates for code C50.A01 include: Independence Blue Cross.

How do I get notified when code C50.A01 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code C50.A01. 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 C50.A01?

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

C50.A01 Insurance Policy Changes

code C50.A01 is referenced in 8 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 C50.A01 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 Jul 13, 2026Medium impact
08.00.90v, Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound)/(Abraxane® for Injectable Suspension)
Independence Blue Cross updated policy 08.00.90v for Abraxane (paclitaxel protein-bound particles) effective July 13, 2026, expanding coverage to include cervical cancer and vaginal cancer per NCCN guidelines. The policy also revised medical necessity criteria across 10 cancer types, updated ICD-10 codes (adding KSHV and immune disorder codes, removing rectal cancer codes and one breast cancer code), and clarified HER2 testing requirements for breast cancer indications.
Independence Blue Cross · Effective Oct 1, 2025Medium impact
MA08.049q, Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound)/(Abraxane® for Injectable Suspension)
Independence Blue Cross updated policy MA08.049q to MA08.049r, adding three new ICD-10 diagnosis codes (C50.A0, C50.A01, C50.A02) for malignant inflammatory neoplasm of the breast effective 10/01/2025. This expands coverage eligibility for Abraxane (paclitaxel protein-bound particles) to include inflammatory breast cancer cases that were previously coded differently.
Independence Blue Cross · Effective Oct 1, 2025Medium impact
08.00.33u, Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta)
Independence Blue Cross updated policy 08.00.33u to version 08.00.33w, adding three new ICD-10 CM diagnosis codes (C50.A0, C50.A01, C50.A02) for malignant inflammatory neoplasm of breast effective 10/01/2025. This affects coverage determination for trastuzumab and related biosimilars in inflammatory breast cancer cases. The policy maintains preferred biosimilar products (Ontruzant, Ogivri, Kanjinti) with non-preferred products requiring documentation of contraindication, intolerance, or inadequate response.
Independence Blue Cross · Effective Oct 1, 2025Low impact
MA08.132e, Margetuximab-cmkb (Margenza)
Independence Blue Cross Medicare Advantage reissued policy MA08.132e for margetuximab-cmkb (Margenza) with no coverage criteria changes. Three new ICD-10 diagnosis codes for malignant inflammatory breast neoplasm (C50.A0, C50.A01, C50.A02) were added effective 10/01/2025 to align with annual ICD-10 updates. Billing teams must ensure these diagnosis codes are available in systems for claims processing.
Independence Blue Cross · Effective Oct 1, 2025Low impact
08.01.75e, Margetuximab-cmkb (Margenza)
Independence Blue Cross reissued Policy 08.01.75e for Margetuximab-cmkb (Margenza) with no substantive coverage changes. Three new ICD-10 CM codes for malignant inflammatory breast neoplasms (C50.A0, C50.A01, C50.A02) were added effective 10/01/2025 to align with annual ICD-10 updates. Billing teams should ensure these diagnosis codes are available in their systems for proper claim coding.
Independence Blue Cross · Effective Oct 1, 2025Low impact
MA08.132e, Margetuximab-cmkb (Margenza)
Independence Blue Cross reissued MA08.132e (Margetuximab-cmkb/Margenza) policy on 07/08/2026 with no substantive changes to coverage criteria. Three new ICD-10 diagnosis codes (C50.A0, C50.A01, C50.A02) for inflammatory breast cancer were added effective 10/01/2025 to align with annual coding updates. Billing teams should verify these diagnosis codes are available in their system for claims requiring HER2-positive breast cancer documentation.
Independence Blue Cross · Effective Oct 1, 2025Low impact
MA08.018k, Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta)
Independence Blue Cross updated MA08.018k to MA08.018m effective 10/01/2025, adding three ICD-10 CM codes for malignant inflammatory neoplasm of breast (C50.A0, C50.A01, C50.A02) to the trastuzumab policy. This is an administrative update to align diagnosis codes with current ICD-10 coding standards and does not change coverage criteria or billing procedures.
Independence Blue Cross · Effective Oct 1, 2025Low impact
08.01.75e, Margetuximab-cmkb (Margenza)
Independence Blue Cross has reissued Policy 08.01.75e for Margetuximab-cmkb (Margenza) with updated ICD-10 CM codes effective October 1, 2025. Three new inflammatory breast cancer diagnosis codes (C50.A0, C50.A01, C50.A02) have been added to the policy. Coverage criteria and clinical requirements remain unchanged from the previous version.

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08.00.90v, Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound)/(Abraxane® for Injectable Suspension)

MA08.049q, Paclitaxel Protein-Bound Particles for Injectable Suspension (Albumin-Bound)/(Abraxane® for Injectable Suspension)

08.00.33u, Trastuzumab (Herceptin®) and Related Biosimilars, Trastuzumab and Hyaluronidase-oysk (Herceptin Hylecta)

MA08.132e, Margetuximab-cmkb (Margenza)

08.01.75e, Margetuximab-cmkb (Margenza)