AVELUMAB (BAVENCIO®) IS MEDICALLY NECESSARY WHEN REPORTED WITH THE FOLLOWING DIAGNOSIS CODES:
|
| C37 | Malignant neoplasm of thymus |
| C4A.0 | Merkel cell carcinoma of lip
|
| C4A.111 | Merkel cell carcinoma of right upper eyelid, including canthus |
| C4A.112 | Merkel cell carcinoma of right lower eyelid, including canthus |
| C4A.121 | Merkel cell carcinoma of left upper eyelid, including canthus |
| C4A.122 | Merkel cell carcinoma of left lower eyelid, including canthus |
| C4A.21 | Merkel cell carcinoma of right ear and external auricular canal |
| C4A.22 | Merkel cell carcinoma of left ear and external auricular canal |
| C4A.31 | Merkel cell carcinoma of nose |
| C4A.39 | Merkel cell carcinoma of other parts of face |
| C4A.4 | Merkel cell carcinoma of scalp and neck |
| C4A.51 | Merkel cell carcinoma of anal skin |
| C4A.52 | Merkel cell carcinoma of skin of breast |
| C4A.59 | Merkel cell carcinoma of other part of trunk |
| C4A.61 | Merkel cell carcinoma of right upper limb, including shoulder |
| C4A.62 | Merkel cell carcinoma of left upper limb, including shoulder |
| C4A.71 | Merkel cell carcinoma of right lower limb, including hip |
| C4A.72 | Merkel cell carcinoma of left lower limb, including hip |
| C4A.8 | Merkel cell carcinoma of overlapping sites |
| C4A.9 | Merkel cell carcinoma, unspecified |
| C54.0 | Malignant neoplasm of isthmus uteri |
| C54.1 | Malignant neoplasm of endometrium |
| C54.2 | Malignant neoplasm of myometrium |
| C54.3 | Malignant neoplasm of fundus uteri |
| C54.8 | Malignant neoplasm of overlapping sites of corpus uteri |
| C54.9 | Malignant neoplasm of corpus uteri, unspecified |
| C55 | Malignant neoplasm of uterus, part unspecified |
| C58 | Malignant neoplasm of placenta |
| C61 | Malignant neoplasm of prostate |
| C64.1 | Malignant neoplasm of right kidney, except renal pelvis |
| C64.2 | Malignant neoplasm of left kidney, except renal pelvis |
| C65.1 | Malignant neoplasm of right renal pelvis |
| C65.2 | Malignant neoplasm of left renal pelvis |
| C66.1 | Malignant neoplasm of right ureter |
| C66.2 | Malignant neoplasm of left ureter |
| C67.0 | Malignant neoplasm of trigone of bladder |
| C67.1 | Malignant neoplasm of dome of bladder |
| C67.2 | Malignant neoplasm of lateral wall of bladder |
| C67.3 | Malignant neoplasm of anterior wall of bladder |
| C67.4 | Malignant neoplasm of posterior wall of bladder |
| C67.5 | Malignant neoplasm of bladder neck |
| C67.6 | Malignant neoplasm of ureteric orifice |
| C67.7 | Malignant neoplasm of urachus |
| C67.8 | Malignant neoplasm of overlapping sites of bladder |
| C67.9 | Malignant neoplasm of bladder, unspecified
|
| C68.0 | Malignant neoplasm of urethra |
| C7A.091 | Malignant carcinoid tumor of the thymus |
| C7B.1 | Secondary Merkel cell carcinoma |
| D09.0 | Carcinoma in situ of bladder |
D39.2
| Neoplasm of uncertain behavior of placenta
|
| O01.9 | Hydatidiform mole, unspecified
|
