45388 CPT® code: payer coverage and prior authorization2 of 2 payer prior-auth lists that name 45388 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Blue Cross and Blue Shield of Texas.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross Blue Shield of Arizona (AZ Blue) | Standard PA code list (most commercial plans) | AZ | prior auth under conditions | place of service 19, 21, 22; site of care: hospital (not ASC) | Sep 1, 2026 | AZ Blue Standard Prior Authorization Requirements Code List (09/01/2026) |
| Blue Cross and Blue Shield of Texas | Texas PA exemption (gold card), outpatient, fully insured | TX | prior auth required | Gold-card exemption available | Jul 1, 2026 | BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range) |
45388 appears in 9 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Centene, Premera Blue Cross, Regence.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Colonoscopy, Colorectal Cancer Screening, and Related Procedures (0516) | covered if criteria are met (range 45378-45393) | Aug 20, 2026 | payer document |
| Aetna | Exhaled Breath Tests (0691) | listed, no stance (range 45378-45398) | Oct 16, 2025 | payer document |
| Aetna | Risankizumab-rzaa (Skyrizi) (1009) | listed, no stance (range 45300-45393) | Jul 1, 2026 | payer document |
| Aetna | Urological Supplies (0533) | listed, no stance (range 45000-45999) | Jul 30, 2026 | payer document |
| Anthem | Colonoscopy (CG-SURG-01) | covered if criteria are met | Aug 13, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Colonoscopy Flexible Sigmoidoscopy And Ct Colonography (L.2.04.403) | covered if criteria are met | payer document | |
| Centene | Anesthesiology Services for Gastrointestinal Endoscopy (CP.MP.161) | covered if criteria are met | May 1, 2019 | payer document |
| Premera Blue Cross | Preventive Care | covered if criteria are met | Sep 21, 2026 | payer document |
| Regence | Surgical Site of Care – Colonoscopy and Sigmoidoscopy (Utilization Management 20) | listed, no stance | Feb 1, 2026 | payer document |
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.