Z85.068 Insurance Policy Changes

ICD-10 Z85.068 is officially defined as "Personal history of other malignant neoplasm of small intestine." code Z85.068 is referenced in 5 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 Z85.068 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 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 · 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.
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.
Blue Cross Blue Shield of North Dakota · Effective May 12, 2026Medium impact
Pharmacy Policy Updates
Blue Cross Blue Shield of North Dakota revised many Commercial prior authorization medical drug policies, with revisions effective May 12, 2026. Changes include new indications such as Darzalex SQ for newly diagnosed multiple myeloma, Keytruda IV and SQ for platinum-resistant ovarian cancer, and management of CAR T-cell and lymphocyte engager-related toxicities for several drugs, along with length of authorization updates, new ICD-10 codes and HCPCS code changes.

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FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code Z85.068?

There are 5 tracked policy changes affecting code Z85.068, 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 Z85.068?

Payers that have issued tracked updates for code Z85.068 include: Blue Cross Blue Shield of North Dakota.

How do I get notified when code Z85.068 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code Z85.068. 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 Z85.068?

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

Pharmacy Policies Available Online

Pharmacy Policy Updates

Pharmacy Policy Updates

Pharmacy Policy Updates

What insurance policy changes affect code Z85.068?

Which payers have updated policy for code Z85.068?

How do I get notified when code Z85.068 policy changes?

Why do payers change policies for code Z85.068?