0486U CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0486U

Payer coverage policies that name 0486U

0486U appears in 17 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Blue Shield of California, BlueCross BlueShield of South Carolina, Cigna, Regence, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaTumor Markers (0352)not coveredAug 25, 2026payer document
Blue Cross & Blue Shield of MississippiGenetic Testing (L.2.04.409)unproven / investigationalpayer document
Blue Cross NCLaboratory Procedures Medical Policy AHS - R2162listed, no stanceJan 1, 2026payer document
Blue Shield of CaliforniaCirculating Tumor DNA and Circulating Tumor Cells for Cancer Management (Liquid Biopsy) (2.04.141)listed, no stancepayer document
BlueCross BlueShield of South CarolinaLaboratory Guideline Policy (CAM 235)listed, no stanceAug 1, 2026payer document
CignaMolecular and Proteomic Diagnostic Testing for Hematology and Oncology Indications (0520)not coveredSep 13, 2026payer document
RegenceCirculating Tumor DNA and Circulating Tumor Cells for Management (Liquid Biopsy) of Solid Tumor Cancers (Laboratory 46)listed, no stanceJun 1, 2026payer document
UnitedHealthcareMolecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions (CS152.AF)listed, no stanceFeb 1, 2026payer document
UnitedHealthcareMolecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions (2026T0588QQ)listed, no stanceAug 1, 2026payer document
UnitedHealthcareMolecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions (for Kansas Only) (CS152KS.05)listed, no stanceMar 1, 2026payer document
UnitedHealthcareMolecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions (for Kentucky Only) (CS152KY.25)listed, no stanceMar 1, 2026payer document
UnitedHealthcareMolecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions (for Louisiana Only) (CS152LA.AA)listed, no stanceFeb 1, 2026payer document
UnitedHealthcareMolecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions (for Nebraska Only) (CS152NE.J)listed, no stanceMar 1, 2026payer document
UnitedHealthcareMolecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions (for New Mexico Only) (CS152NM.G)listed, no stanceFeb 1, 2026payer document
UnitedHealthcareMolecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions (for Ohio Only) (CS152OH.I)listed, no stanceApr 1, 2026payer document
UnitedHealthcareMolecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions (for Pennsylvania Only) (CS152PA.AD)listed, no stanceJul 1, 2026payer document
UnitedHealthcareMolecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions (for Tennessee Only) (CS152TN.AF)listed, no stanceFeb 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN, MS.

  • AZ: $1644.25 (lab), effective Oct 1, 2026
  • FL: $887.90 (lab_independent, non-facility), effective Jan 1, 2026
  • KY: $1644.25 (lab), effective Jan 1, 2026
  • MS: $1479.83 (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.