`0381U` CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0381U

Payer coverage policies that name 0381U

0381U appears in 2 coverage policies from Blue Cross NC, Cigna.

Payer	Policy	Role in policy	Reviewed	Document
Blue Cross NC	Laboratory Procedures Medical Policy AHS - R2162	listed, no stance	Jan 1, 2026	payer document
Cigna	Laboratory Testing Services (0604)	not covered	May 15, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN, MS.

FL: $23.82 (lab_independent, non-facility), effective Jan 1, 2026
KY: $44.12 (lab), effective Jan 1, 2026
MS: $39.71 (comprehensive), effective Jul 1, 2026
ND: $0.00 (physician), effective Aug 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.

0381U CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0381U

Payer coverage policies that name 0381U

Medicaid fee-for-service

`0381U` CPT® code: payer coverage and prior authorization