Z85.118 Insurance Policy Changes

ICD-10 Z85.118 is officially defined as "Personal history of other malignant neoplasm of bronchus and lung." code Z85.118 is referenced in 4 tracked payer policy changes from Blue Cross Blue Shield of North Dakota and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code Z85.118 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 Mar 17, 2026Medium impact
Pharmacy Policies Available Online
Commercial prior authorization medical drug policies have revisions effective March 17, 2026, with many policies adding the Appendix A NQTL Factor Checklist, showing the number of days allowed for authorization durations, and replacing 'coverage' with 'prior authorization validity' in the initial and renewal criteria. Clinical updates include Eylea HD for macular edema following retinal vein occlusion, Breyanzi for relapsed or refractory marginal zone lymphoma, and new appendiceal neoplasm and cancer indications with ICD-10 codes D37.3 and Z85.038. Commercial post service claim edit policies for Trogarzo have revisions effective Feb. 1, 2026.
Blue Cross Blue Shield of North Dakota · Effective Jan 13, 2026Medium impact
Pharmacy Policies Updates
BCBSND's Commercial post service claim edit medical drug policies have revisions effective Dec. 1, 2025, and its Commercial prior authorization medical drug policies have revisions effective Jan. 13, 2026. Most of these policies now separate Length of Authorization durations for initial and renewal periods, add the Appendix A Non-Quantitative Treatment Limitations (NQTL) Factor Checklist, and replace 'coverage' with 'prior authorization validity' in the initial and renewal criteria. Several policies also remove discontinued HCPCS codes, add ICD-10 covered diagnosis codes, and update oncology criteria to align with NCCN guidelines.
Aetna · Identified Aug 19, 2026Medium impact
Lung Cancer Screening (CPB 0380, reviewed 2026-05-28)
Aetna covers annual low-dose CT (LDCT) lung cancer screening, CPT 71271, for current or former smokers ages 50 to 80 with a 20 pack-year or more smoking history, and former smokers must have quit within the past 15 years. Annual LDCT is also covered for surveillance of non-small cell lung cancer, starting 2 years after definitive treatment, using CPT 71250. Artificial intelligence-based imaging, computer-aided detection for chest radiographs, PET for lung cancer screening, and LDCT screening for other indications such as asbestos-exposed individuals are considered experimental, investigational or unproven.
Aetna · Identified Aug 15, 2026Medium impact
Cardiopulmonary Exercise Testing (CPB 0825, reviewed 2025-12-03)
Aetna considers cardiopulmonary exercise testing (CPET, CPT 94621) medically necessary for listed conditions after standard testing, including echocardiography, pulmonary function testing with diffusion capacity, and oxygen desaturation measured on the 6-minute walk test. The listed conditions include post-operative evaluation of chronic thromboembolic pulmonary hypertension after pulmonary thromboendarterectomy, developing exercise prescriptions for cardiac or pulmonary rehabilitation, evaluating exercise capacity and response to therapy in chronic heart failure patients considered for heart transplantation or other advanced therapies, and evaluating post-acute sequelae of COVID-19 (Long COVID). CPET is considered experimental, investigational or unproven as a screening exercise test, as a routine pre-operative assessment, and as a first-line diagnostic test for possible cardiac or pulmonary pathology.

Watch Z85.118

Get one email when a payer policy names Z85.118, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

No account needed. We send a confirmation link first, and every email has a one-click stop link.

FREQUENTLY ASKED QUESTIONS

What insurance policy changes affect code Z85.118?

There are 4 tracked policy changes affecting code Z85.118, including updates from Blue Cross Blue Shield of North Dakota, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code Z85.118?

Payers that have issued tracked updates for code Z85.118 include: Blue Cross Blue Shield of North Dakota, Aetna.

How do I get notified when code Z85.118 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code Z85.118. 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 Z85.118?

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

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

Pharmacy Policies Available Online

Pharmacy Policies Updates

Lung Cancer Screening (CPB 0380, reviewed 2026-05-28)

Cardiopulmonary Exercise Testing (CPB 0825, reviewed 2025-12-03)

What insurance policy changes affect code Z85.118?

Which payers have updated policy for code Z85.118?

How do I get notified when code Z85.118 policy changes?

Why do payers change policies for code Z85.118?