81003 CPT® code: payer coverage and prior authorization81003 appears in 12 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Eating Disorders (0511) | covered if criteria are met (range 81000-81005) | Aug 4, 2026 | payer document |
| Aetna | Erectile Dysfunction and Peyronie's Disease (0007) | covered if criteria are met (range 81000-81003) | Jul 29, 2026 | payer document |
| Aetna | Gene-Based Therapy for Duchenne Muscular Dystrophy (DMD) (0911) | listed, no stance (range 81000-81003) | Aug 5, 2026 | payer document |
| Aetna | Hospitalization for the Initiation of Ketogenic Diet (0226) | listed, no stance (range 81000-81003) | Apr 23, 2026 | payer document |
| Aetna | Myalgic Encephalomyelitis - Chronic Fatigue Syndrome (ME/CSF) (0369) | covered if criteria are met (range 81000-81099) | May 20, 2026 | payer document |
| Aetna | Parenteral Immunoglobulins (0206) | listed, no stance (range 81000-81005) | Oct 8, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Pathogen Panel Testing (L.2.04.456) | not covered | payer document | |
| Blue Cross & Blue Shield of Mississippi | Urinalysis (L.2.04.418) | listed, no stance | payer document | |
| Blue Cross NC | Prenatal Screening (Nongenetic) AHS - G2035 | listed, no stance | Oct 1, 2025 | payer document |
| Cigna | Laboratory Testing Services (0604) | not covered | May 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Sexual Dysfunctions, Assessment and Treatment (MED201.030) CPT Codes 37788, 37790, 54110, 54111, 54112, 54200, 54205, 54230, 54231, | listed, no stance | Jan 1, 2026 | payer document |
| Premera Blue Cross | Preventive Care Bacteriuria screening: Pregnant women and urinary tract | covered if criteria are met | Sep 21, 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.