77080 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 77080

1 of 1 payer prior-auth lists that name 77080 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue).

PayerPlanStatePrior authConditionsSinceSource
Blue Cross Blue Shield of Arizona (AZ Blue)Teamsters group (TYW)AZprior auth requiredGold-card eligibleSep 1, 2026Teamsters Group Prior Authorization Requirements Code List (Updated 09/01/2026)

Payer coverage policies that name 77080

77080 appears in 12 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Premera Blue Cross, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaBack Pain - Invasive Procedures (0016)listed, no stanceOct 6, 2026payer document
AetnaBiochemical Markers of Bone Remodeling (0562)listed, no stance (range 77080-77081)Aug 21, 2026payer document
AetnaBone Mass Measurements (0134)covered if criteria are met (range 77080-77081)Mar 19, 2026payer document
AetnaEating Disorders (0511)covered if criteria are met (range 77080-77081)Aug 4, 2026payer document
AetnaIntervertebral Disc Prostheses (0591)listed, no stanceSep 18, 2026payer document
AnthemBone Mineral Density Testing Measurement (CG-RAD-32)covered if criteria are metAug 13, 2026payer document
Blue Cross & Blue Shield of MississippiBone Mineral Density Studies (L.6.01.412)covered if criteria are metpayer document
Blue Cross Blue Shield of MassachusettsMineral Density Studies (450)listed, no stancepayer document
Blue Cross NCBone Mineral Density Studieslisted, no stanceMar 1, 2026payer document
Premera Blue CrossBone Mineral Density Studies (6.01.521)listed, no stanceNov 10, 2025payer document
Premera Blue CrossPreventive Care
Procedure Code(s) | Comments
covered if criteria are metSep 21, 2026payer document
UnitedHealthcarePreventive Care Services (MP.016.59)
Osteoporosis Screening | Procedure Code(s): | Requires one of the diagnosis codes
listed, no stanceJul 1, 2026payer document

Recent prior-auth changes

  • Apr 1, 2023: PA removed, Blue Shield of California Promise Health Plan

Medicaid fee-for-service

Prior authorization required or conditional in WA, WV.

  • AZ: $16.35 (asc), effective Oct 1, 2026
  • CO: $40.07 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $7.01 (radiology), effective Jan 1, 2026
  • IL: $35.82 (practitioner), effective Apr 1, 2024
  • IN: $22.70 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $5.80 (default, Exempt Physician), effective Jan 1, 2024
  • KY: $29.17 (asc), effective Jan 1, 2026
  • LA: $61.52 (lab_radiology), effective Jul 1, 2012
  • MA: $6.97 (physician_radiology), effective May 1, 2024
  • MS: $23.03 (comprehensive, facility), effective Oct 1, 2025
  • ND: $28.84 (physician, facility), effective Aug 1, 2026
  • NE: $103.37 (physician, non-facility), effective Jul 1, 2026
  • NY: $101.00 (ordered_ambulatory), effective Jul 24, 2026
  • OH: $34.90 (physician), effective Jan 1, 2018
  • OK: $26.61 (asc), effective Jan 1, 2026
  • TX: $131.99 (hospital_outpatient_imaging_services, Rural Hospitals), effective Mar 1, 2025
  • VA: $34.14 (medical), effective Jul 1, 2026
  • VT: $81.18 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $24.46 (physician, facility), effective Jul 1, 2026
  • WY: $46.23 (outpatient_hospital_apc, Ambulatory Surgical Centers), 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.