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: Apr 24, 2026

Blue Cross Blue Shield of Arkansas - Pharmacy Prior Authorization Form Arkansas Blue Cross Blue Shield · Updated Apr 24, 2026

Blue Cross of Idaho - General Prior Authorization Form Blue Cross of Idaho Health Services, Inc. · Updated Apr 24, 2026

California - Uniform Prior Authorization FormCalifornia · Updated Apr 16, 2026

CDPHP - General Prior Authorization FormCapital District Physicians Health Plan, Inc. · Updated Apr 24, 2026

Cigna - General Medication Prior Authorization FormCigna Corporation · Updated Apr 24, 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

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.

Pharmacy List Pharmacy List resource

Prior Authorization Checklist Prior Authorization Checklist resource

Coverage Authorization Request Coverage Authorization Request resource

Reimbursement InformationReimbursement Information resource