Avastin 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 May 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 - Avastin Prior Authorization FormCigna Corporation · Updated May 16, 2026

ICD-10 codes for Avastin Prior Authorizations

C18.9Malignant neoplasm of colon, unspecified
C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
C71.9Malignant neoplasm of brain, unspecified
C64.9Malignant neoplasm of unspecified kidney, except renal pelvis
C53.9Malignant neoplasm of cervix uteri, unspecified
C56.9Malignant neoplasm of unspecified ovary
C57.4Malignant neoplasm of uterine adnexa, unspecified
C48.1Malignant neoplasm of specified parts of peritoneum
C22.0Liver cell carcinoma

Appeal Templates

If the payer denies coverage, these templates help you build a stronger appeal.
Coverage Authorization Appeals Coverage Authorization Appeals 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

Formulary Information Formulary Information resource
Reimbursement Information Reimbursement Information resource
Billing & Coding Guide: Metastatic Colorectal Cancer (mCRC)Billing & Coding Guide: Metastatic Colorectal Cancer (mCRC) resource
Billing & Coding Guide: Non–Small Cell Lung Cancer (NSCLC)Billing & Coding Guide: Non–Small Cell Lung Cancer (NSCLC) resource
Billing & Coding Guide: Metastatic Kidney Cancer (mRCC)Billing & Coding Guide: Metastatic Kidney Cancer (mRCC) resource
Billing & Coding Guide: Recurrent Glioblastoma (GBM)Billing & Coding Guide: Recurrent Glioblastoma (GBM) resource
Billing & Coding Guide: Ovarian Cancer (OC) Billing & Coding Guide: Ovarian Cancer (OC) resource
Billing & Coding Guide: Hepatocellular Cancer (HCC)Billing & Coding Guide: Hepatocellular Cancer (HCC) resource
Patient Consent Form Patient Consent Form resource
Patient Consent Form - SpanishPatient Consent Form - Spanish resource

Support for Getting Your Patient on Avastin

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.