86141 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 86141

Payer coverage policies that name 86141

86141 appears in 34 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Blue Shield of California, BlueCross BlueShield of South Carolina, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaAbatacept (Orencia) (0720)listed, no stanceJul 1, 2026payer document
AetnaAdalimumab (0655)listed, no stanceJul 13, 2026payer document
AetnaCardiovascular Disease Risk Tests (0381)covered if criteria are metAug 25, 2026payer document
AetnaCertolizumab Pegol (Cimzia) (0761)listed, no stanceJul 1, 2026payer document
AetnaColonoscopy, Colorectal Cancer Screening, and Related Procedures (0516)not covered (range 86140-86141)Aug 20, 2026payer document
AetnaEtanercept (0315)
CD11c expression and DNA methylation as biomarkers of etanercept response		listed, no stanceJul 8, 2026payer document
AetnaFetal Fibronectin, Inflammatory Biomarkers, and Salivary Hormone Testing for Preterm Labor (0166)not covered (range 86140-86141)Apr 21, 2026payer document
AetnaGolimumab (Simponi and Simponi Aria) (0790)listed, no stanceJul 31, 2026payer document
AetnaGuselkumab (Tremfya) (1011)listed, no stanceJun 29, 2026payer document
AetnaHip Arthroplasty (0287)not covered (range 86140-86141)Sep 23, 2026payer document
AetnaInfliximab (0341)listed, no stanceOct 5, 2026payer document
AetnaMyalgic Encephalomyelitis - Chronic Fatigue Syndrome (ME/CSF) (0369)not coveredMay 20, 2026payer document
AetnaNonstandard Laboratory Test Panels (0499)listed, no stanceAug 3, 2026payer document
AetnaObesity Surgery (0157)
Sleeve gastrectomy with SIPS, Laparoscopic single-anastomosis duodeno-ileal bypass with gastric plication		not coveredJul 21, 2026payer document
AetnaObstructive Sleep Apnea in Adults (0004)not coveredOct 6, 2026payer document
AetnaParenteral Immunoglobulins (0206)listed, no stanceOct 8, 2026payer document
AetnaRilonacept (Arcalyst) (0770)listed, no stanceSep 11, 2026payer document
AetnaRisankizumab-rzaa (Skyrizi) (1009)listed, no stanceJul 1, 2026payer document
AetnaRituximab (0314)listed, no stanceSep 15, 2026payer document
AetnaTocilizumab (0799)listed, no stanceJun 30, 2026payer document
AetnaUstekinumab (0912)listed, no stanceJul 1, 2026payer document
Blue Cross & Blue Shield of MississippiHigh Sensitivity Creactive Protein Crp (L.2.04.410)unproven / investigationalpayer document
Blue Cross Blue Shield of MassachusettsHigh Sensitivity C-Reactive Protein (032)listed, no stancepayer document
Blue Cross NCBiomarkers for Myocardial Infarction and Chronic Heart Failure AHS - G2150listed, no stanceJul 1, 2025payer document
Blue Cross NCCardiovascular Disease Risk Assessment AHS – G2050listed, no stanceApr 1, 2026payer document
Blue Cross NCGeneral Inflammation Testing AHS - G2155listed, no stanceJul 1, 2025payer document
Blue Cross NCPancreatic Enzyme Testing for Acute Pancreatitis AHS – G2153listed, no stanceApr 1, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 86000-86999)Mar 1, 2024payer document
Blue Shield of CaliforniaBiomarker Testing in Risk Assessment and Management of Cardiovascular Disease (2.04.65)listed, no stancepayer document
BlueCross BlueShield of South CarolinaCardiovascular Disease Risk Assessment (CAM 188)listed, no stanceApr 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Biomarker Testing in Risk Assessment and Management of Cardiovascular Disease (MED207.008)
CPT Codes 81291, 81401, 82172, 82397, 82465, 82610, 82652, 82664, 83090,		listed, no stanceJul 15, 2026payer document
Premera Blue CrossCardiovascular Risk Panels (2.04.509)listed, no stanceFeb 23, 2026payer document
Premera Blue CrossGeneral Inflammation Testinglisted, no stanceOct 14, 2025payer document

Medicaid fee-for-service

  • AZ: $12.95 (lab), effective Oct 1, 2026
  • CO: $11.01 (lab_cdl), effective Apr 1, 2026
  • FL: $6.99 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $12.95 (practitioner), effective Apr 1, 2024
  • IN: $11.01 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $8.26 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $12.95 (lab), effective Jan 1, 2026
  • LA: $12.95 (lab_radiology), effective Jan 1, 2020
  • MS: $11.66 (comprehensive), effective Jul 1, 2026
  • ND: $12.95 (physician), effective Aug 1, 2026
  • NE: $12.95 (lab), effective Jul 1, 2026
  • NY: $10.35 (lab), effective Aug 1, 2026
  • OH: $9.71 (lab), effective Apr 1, 2021
  • OK: $11.52 (physician, non-facility), effective Jul 1, 2026
  • VA: $5.88 (medical), effective Jan 1, 2016
  • VT: $12.63 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $10.36 (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.