83876 CPT® code: payer coverage and prior authorization1 of 1 payer prior-auth lists that name 83876 require prior authorization or set conditions: Rocky Mountain Health Plans.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Rocky Mountain Health Plans | Rocky Mountain Medicare Advantage D-SNP | CO | prior auth required | Feb 1, 2025 | Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025 |
83876 appears in 7 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Cigna.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Cardiovascular Disease Risk Tests (0381) | not covered | Aug 25, 2026 | payer document |
| Aetna | Inflammatory Disease: Biomarker and Thiopurine Pharmacogenomic Testing (0249) | not covered | Apr 27, 2026 | payer document |
| Aetna | Tumor Markers (0352) | covered if criteria are met | Aug 25, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Myeloperoxidase Mpo Immunoassay For Cardiac Disease Risk (L.2.02.401) | unproven / investigational | payer document | |
| Blue Cross NC | Cardiovascular Disease Risk Assessment AHS – G2050 | listed, no stance | Apr 1, 2026 | payer document |
| Blue Cross NC | Professional Pathology Billing Requirements AHS – R2169 | listed, no stance (range 83001-83993) | Mar 1, 2024 | payer document |
| Cigna | Laboratory Testing Services (0604) | not covered | May 15, 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.