19085 CPT® code: payer coverage and prior authorization19085 appears in 6 coverage policies from Aetna, BlueCross BlueShield of South Carolina, Premera Blue Cross, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Breast Biopsy Procedures (0269) | covered if criteria are met | May 14, 2026 | payer document |
| Aetna | Magnetic Resonance Imaging (MRI) of the Breast (0105) | covered if criteria are met | Aug 6, 2026 | payer document |
| Aetna | Skin and Soft Tissue Substitutes (0244) | not covered (range 10040-19499) | Jul 29, 2026 | payer document |
| BlueCross BlueShield of South Carolina | Radioactive Seed Localization of Nonpalpable Breast Lesions (CAM 60157) | listed, no stance (range 19081-19086) | Oct 1, 2025 | payer document |
| Premera Blue Cross | Preventive Care Breast cancer screening Ultrasound, mammography, and MRI | covered if criteria are met | Sep 21, 2026 | payer document |
| UnitedHealthcare | Preventive Care Services (MP.016.59) Procedure Code(s): | No age limit. Requires one of the | listed, no stance | Jul 1, 2026 | payer document |
Prior authorization required or conditional in WA.
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.