Payer policies › CPT 8458084580 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 84580 Payer coverage policies that name 84580 84580 appears in 2 coverage policies from Blue Cross NC, Cigna.
Payer Policy Role in policy Reviewed Document Blue Cross NC Professional Pathology Billing Requirements AHS – R2169 listed, no stance (range 84030-84999) Mar 1, 2024 payer document Cigna Laboratory Testing Services (0604) not covered May 15, 2026 payer document
Medicaid fee-for-service AZ: $9.55 (lab), effective Oct 1, 2026 CO: $8.12 (lab_cdl), effective Apr 1, 2026 FL: $5.16 (lab_independent, non-facility), effective Jan 1, 2026 IL: $6.69 (practitioner), effective Apr 1, 2024 IN: $8.12 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2019 KS: $5.40 (default, Exempt Physician), effective Jul 1, 1987 KY: $9.55 (lab), effective Jan 1, 2026 LA: $8.12 (lab_radiology), effective Jul 1, 2025 MS: $8.60 (comprehensive), effective Jul 1, 2026 ND: $9.55 (physician), effective Aug 1, 2026 NE: $9.55 (lab), effective Jul 1, 2026 OH: $7.16 (lab), effective Apr 1, 2021 OK: $8.49 (physician, non-facility), effective Jul 1, 2026 VA: $4.39 (medical), effective Jul 1, 2014 VT: $9.31 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $7.64 (physician, facility), 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.