0403U CPT® code: payer coverage and prior authorization0403U appears in 5 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, BlueCross BlueShield of South Carolina, Regence.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Tumor Markers (0352) | not covered | Aug 25, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Genetic Testing (L.2.04.409) | unproven / investigational | payer document | |
| Blue Cross NC | Gene Expression Profiling and Protein Biomarkers for Prostate Cancer AHS - M2166 | listed, no stance | Apr 1, 2026 | payer document |
| BlueCross BlueShield of South Carolina | Gene Expression Profiling and Protein Biomarkers for Prostate Cancer (CAM 241) 86316 | Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each | listed, no stance | Apr 1, 2026 | payer document |
| Regence | Gene-Based Tests for Screening, Detection, and Management of Prostate or Bladder Cancer (Genetic Testing 17) | listed, no stance | Nov 1, 2025 | payer document |
Prior authorization required or conditional in IN, MS.
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.