81510 CPT® code: payer coverage and prior authorization3 of 3 payer prior-auth lists that name 81510 require prior authorization or set conditions: Humana.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Humana | Humana Healthy Horizons | KY | prior auth required | Jan 1, 2027 | please visit Humana Healthy Horizons in Kentucky Clinical coverage policies. | |
| Humana | Humana Healthy Horizons | OH | prior auth required | Jan 1, 2027 | 555201OH0924-B OHHMZG2EN Humana Healthy Horizons® in Ohio Prior Authorization Notification List (PAL) The following preauthorization and notification list | |
| Humana | Humana Healthy Horizons | SC | prior auth required | Jan 1, 2027 | Humana Healthy Horizons in South Carolina Prior authorization and Notification List The following list describes services and medications that are commonly reviewed and may require additional clinical |
81510 appears in 5 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Cigna.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Maternal Biomarker Screening for Fetal Conditions (0464) | covered if criteria are met (range 81510-81512) | Jul 17, 2026 | payer document |
| Aetna | Noninvasive Down Syndrome Screening (0282) | covered if criteria are met | Apr 17, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Firsttrimester Detection Of Down Syndrome Using Fetal Ultrasound Markers Combined With Maternal Serum Assessment (L.4.01.404) | covered if criteria are met | payer document | |
| Blue Cross NC | Prenatal Testing for Fetal Aneuploidy AHS - G2055 | listed, no stance | Jan 1, 2026 | payer document |
| Cigna | Laboratory Testing Services (0604) | not covered | May 15, 2026 | payer document |
Prior authorization required or conditional in IN, MS.
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.