Keytruda Prior Authorization Resources

Find the right PA form for your patient's payer, get the ICD-10 codes you need, and download appeal templates — all in one place.

Last verified: May 11, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated May 11, 2026
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc. · Updated May 11, 2026
California - Uniform Prior Authorization FormCalifornia · Updated Apr 16, 2026
CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated May 11, 2026
Cigna - General Medication Prior Authorization FormCigna Corporation · Updated May 11, 2026
Cigna - Keytruda Prior Authorization Form Cigna Corporation · Updated Apr 16, 2026

ICD-10 codes for Keytruda Prior Authorizations

C43Malignant melanoma of skin
C34Malignant neoplasm of bronchus and lung
C45.0Mesothelioma of pleura
C32.9Malignant neoplasm of larynx, unspecified
C81Hodgkin lymphoma
C83Non-follicular lymphoma
C67Malignant neoplasm of bladder
C18Malignant neoplasm of colon
C16Malignant neoplasm of stomach
C15Malignant neoplasm of esophagus
C53Malignant neoplasm of cervix uteri
C22Malignant neoplasm of liver and intrahepatic bile ducts
C24Malignant neoplasm of other and unspecified parts of biliary tract
C44Other and unspecified malignant neoplasm of skin
C64Malignant neoplasm of kidney, except renal pelvis
C54Malignant neoplasm of corpus uteri
C50Malignant neoplasm of breast
C56Malignant neoplasm of ovary

Appeal Templates

If the payer denies coverage, these templates help you build a stronger appeal.
Appeals Checklist Appeals Checklist resource
Coverage Authorization Appeals Coverage Authorization Appeals resource
A peer-to-peer review with the payer's medical director can often resolve denials faster than a formal appeal.

Brand Resources

Pharmacy List Pharmacy List resource
Prior Authorization Checklist Prior Authorization Checklist resource
Coverage Authorization Request Coverage Authorization Request resource
Reimbursement InformationReimbursement Information resource

Support for Getting Your Patient on Keytruda

Check coverage & formulary statusVerify PA requirements for your patient's plan.Find savings programsCopay cards, patient assistance, and more.Check medication interactionsScreen prescriptions for harmful drug combinations.