83497 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 83497

Payer coverage policies that name 83497

83497 appears in 10 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaGout (0810)not coveredMar 27, 2026payer document
AetnaLyme Disease and other Tick-Borne Diseases (0215)
Alpha lipoic acid or “Healing” Detox Drips, testing for other tick-borne diseases from other organisms, antibiotic augmented thermo-eradication (AAT) therapy
not coveredJul 21, 2026payer document
AetnaNonstandard Laboratory Test Panels (0499)listed, no stanceAug 3, 2026payer document
AetnaTumor Markers (0352)covered if criteria are metAug 25, 2026payer document
Blue Cross & Blue Shield of MississippiOrganic Acid Testing (L.2.04.413)not coveredpayer document
Blue Cross NCDiagnosis of Idiopathic Environmental Intolerance AHS - G2056listed, no stanceJan 1, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 83001-83993)Mar 1, 2024payer document
BlueCross BlueShield of South CarolinaDiagnosis and Management of Idiopathic Environmental Intolerance (i.e., Clinical Ecology) (CAM 267)
Code Number
listed, no stanceJan 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document
Premera Blue CrossDiagnosis of Idiopathic Environmental Intolerancelisted, no stanceFeb 6, 2026payer document

Medicaid fee-for-service

  • AZ: $12.90 (lab), effective Oct 1, 2026
  • CO: $12.90 (lab_cdl), effective Oct 1, 2025
  • FL: $6.97 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $12.64 (practitioner), effective Oct 1, 2008
  • IN: $10.96 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $9.68 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $12.90 (lab), effective Jan 1, 2026
  • LA: $12.82 (lab_radiology), effective Jul 1, 2012
  • MS: $11.61 (comprehensive), effective Jul 1, 2026
  • ND: $12.90 (physician), effective Aug 1, 2026
  • NE: $12.90 (lab), effective Jul 1, 2026
  • NY: $12.90 (lab), effective Aug 1, 2026
  • OH: $9.68 (lab), effective Apr 1, 2021
  • OK: $11.47 (physician, non-facility), effective Jul 1, 2026
  • VA: $5.38 (medical), effective Jul 1, 2014
  • VT: $12.58 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $10.32 (kidneycenters), effective Jul 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.