84078 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 84078

Payer coverage policies that name 84078

84078 appears in 7 coverage policies from Aetna, Blue Cross NC, Blue Shield of California, Cigna, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaBiochemical Markers of Bone Remodeling (0562)not covered (range 84075-84080)Aug 21, 2026payer document
AetnaEtranacogene Dezaparvovec-drlb (Hemgenix) (1023)listed, no stanceApr 17, 2026payer document
AetnaZoledronic Acid (0524)listed, no stanceFeb 12, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 84030-84999)Mar 1, 2024payer document
Blue Shield of CaliforniaBone Turnover Markers for Diagnosis and Management of Osteoporosis and Diseases Associated With High Bone Turnover (2.04.15)listed, no stancepayer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document
Premera Blue CrossSerum Tumor Markers for Malignancieslisted, no stanceOct 1, 2026payer document

Medicaid fee-for-service

  • AZ: $8.26 (lab), effective Oct 1, 2026
  • CO: $7.02 (lab_cdl), effective Apr 1, 2026
  • FL: $4.46 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $7.16 (practitioner), effective Feb 1, 2013
  • IN: $7.02 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2019
  • KS: $5.91 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $8.26 (lab), effective Jan 1, 2026
  • LA: $7.02 (lab_radiology), effective Jul 1, 2025
  • MS: $7.43 (comprehensive), effective Jul 1, 2026
  • ND: $8.26 (physician), effective Aug 1, 2026
  • NE: $8.26 (lab), effective Jul 1, 2026
  • NY: $5.08 (lab), effective Aug 1, 2026
  • OH: $6.20 (lab), effective Apr 1, 2019
  • OK: $7.35 (physician, non-facility), effective Jul 1, 2026
  • VA: $2.63 (medical), effective Jul 1, 2014
  • VT: $8.05 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $6.61 (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.