Payer policies › CPT 8534585345 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 85345 Payer coverage policies that name 85345 85345 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 85300-85397) Mar 1, 2024 payer document Cigna Laboratory Testing Services (0604) not covered May 15, 2026 payer document
Medicaid fee-for-service AZ: $4.69 (lab), effective Oct 1, 2026 CO: $4.69 (lab_cdl), effective Oct 1, 2025 FL: $2.63 (lab_independent, non-facility), effective Jan 1, 2026 IL: $3.00 (podiatrist), effective Apr 1, 2024 IN: $3.99 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020 KS: $4.46 (default, Exempt Physician), effective Jan 1, 1996 KY: $4.69 (lab), effective Jan 1, 2026 LA: $4.28 (lab_radiology), effective Jul 1, 2012 MS: $4.22 (comprehensive), effective Jul 1, 2026 ND: $4.69 (physician), effective Aug 1, 2026 NE: $4.69 (lab), effective Jul 1, 2026 OH: $3.52 (lab), effective Apr 1, 2021 OK: $4.17 (physician, non-facility), effective Jul 1, 2026 VA: $2.81 (medical), effective Jul 1, 2014 VT: $4.57 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $3.75 (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.