C79.32 Insurance Policy Changes

ICD-10 C79.32 is officially defined as "Secondary malignant neoplasm of cerebral meninges." code C79.32 is referenced in 5 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 C79.32 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 · Identified Aug 29, 2026High impact
Pharmacy Policies Available Online
Blue Cross Blue Shield of North Dakota revised its Commercial prior authorization medical drug policies with changes effective October 13, 2026, including expanded indications for Casgevy, Keytruda, Opdivo and other products and updated criteria for many others. Effective September 1, 2026, Navitrux was added to the fosaprepitant policy and Cligavyx was added to the fulvestrant policy, each kept at full parity with its reference product, and the cerebral palsy spasticity exclusion was removed from the Xeomin pediatric upper limb indication. Several products also have HCPCS code changes effective January 1, 2027.
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.
Aetna · Identified Aug 12, 2026Medium impact
Optical Coherence Tomography and Microelastography for Solid Tumors and Other Selected Indications (CPB 0886, reviewed 2026-03-03)
Aetna considers optical coherence tomography and microelastography experimental, investigational, or unproven for the listed intra-operative uses because their effectiveness has not been established. These uses include assessment of lymph nodes or tumor margins in breast conserving surgery, differentiation of pancreatic neoplastic lesions, differentiation of normal and diseased thyroid and parathyroid tissues, and solid tumor surgery including optical biopsy of lymph nodes and real-time determination of surgical margins. The policy lists CPT codes and ICD-10 codes as not covered for the indications it names.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Intensity-Modulated Radiotherapy (IMRT): Central Nervous System Tumors
IMRT may be considered medically necessary for individuals with malignant or benign brain tumors when the tumor is proximate to organs at risk (brain stem, spinal cord, cochlea, and eye structures) and 3-dimensional conformal radiotherapy planning cannot meet dose-volume constraints for normal tissue tolerance. Hippocampal-avoiding IMRT may be considered medically necessary for individuals with brain tumor metastases outside a 5-mm margin around either hippocampus and expected survival of 4 months or more. IMRT is considered investigational for tumors of the central nervous system for all other indications.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Oncologic Applications of Positron Emission Tomography (PET) Scanning
FDG-PET or FDG-PET/CT may be considered medically necessary for listed cancers when specific criteria are met, such as staging or restaging of muscle-invasive bladder cancer, Ewing sarcoma and osteosarcoma, brain cancer, lymphoma, and multiple myeloma. PET for surveillance, meaning scans performed more than 6 months after completion of cancer therapy (12 months for lymphoma) in individuals without objective signs or symptoms of recurrence, is considered investigational, and fluoroestradiol F18 PET in individuals with breast cancer is considered investigational. The medically necessary situations assume that the PET results will influence treatment decisions, and if the results will not influence treatment decisions, those situations are considered not medically necessary.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code C79.32?

There are 5 tracked policy changes affecting code C79.32, 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 C79.32?

Payers that have issued tracked updates for code C79.32 include: Blue Cross Blue Shield of North Dakota, Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when code C79.32 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code C79.32. 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 C79.32?

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 Policy Updates

Optical Coherence Tomography and Microelastography for Solid Tumors and Other Selected Indications (CPB 0886, reviewed 2026-03-03)

Intensity-Modulated Radiotherapy (IMRT): Central Nervous System Tumors

Oncologic Applications of Positron Emission Tomography (PET) Scanning

What insurance policy changes affect code C79.32?

Which payers have updated policy for code C79.32?

How do I get notified when code C79.32 policy changes?

Why do payers change policies for code C79.32?