Opdivo 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 08, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated May 08, 2026
Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc. · Updated May 08, 2026
California - Uniform Prior Authorization FormCalifornia · Updated Apr 16, 2026
CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated May 08, 2026
Cigna - General Medication Prior Authorization FormCigna Corporation · Updated May 08, 2026
Cigna - Opdivo Prior Authorization Form Cigna Corporation · Updated Apr 16, 2026

ICD-10 codes for Opdivo Prior Authorizations

C80.1Malignant (primary) neoplasm, unspecified
C34.9Malignant neoplasm of unspecified part of bronchus or lung
C45.9Mesothelioma, unspecified
C64.9Malignant neoplasm of unspecified kidney, except renal pelvis
C81.9Hodgkin lymphoma, unspecified
C32.9Malignant neoplasm of larynx, unspecified
C67.9Malignant neoplasm of bladder, unspecified
C18.9Malignant neoplasm of colon, unspecified
C22.9Malignant neoplasm of liver, not specified as primary or secondary
C15.9Malignant neoplasm of esophagus, unspecified
C16.9Malignant neoplasm of stomach, unspecified
C16Malignant neoplasm of stomach

Appeal Templates

If the payer denies coverage, these templates help you build a stronger appeal.
Coverage Authorization Appeals Coverage Authorization Appeals resource
Commercial Claim Denial Appeal/Redetermination LetterCommercial Claim Denial Appeal/Redetermination Letter resource
Medically Unlikely Edit (MUE) Appeal LetterMedically Unlikely Edit (MUE) Appeal Letter resource
Letter of Medical Necessity Letter of Medical Necessity resource
A peer-to-peer review with the payer's medical director can often resolve denials faster than a formal appeal.

Brand Resources

Billing & Coding Guide Billing & Coding Guide resource
Formulary InformationFormulary Information resource
Reimbursement InformationReimbursement Information resource

Support for Getting Your Patient on Opdivo

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