Payer policies › CPT 8628086280 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 86280 Payer coverage policies that name 86280 86280 appears in 4 coverage policies from Blue Cross NC, Cigna, Premera Blue Cross.
Payer Policy Role in policy Reviewed Document Blue Cross NC Professional Pathology Billing Requirements AHS – R2169 listed, no stance (range 86000-86999) Mar 1, 2024 payer document Blue Cross NC Testing for Vector-Borne Infections AHS – G2158 listed, no stance Oct 1, 2025 payer document Cigna Laboratory Testing Services (0604) not covered May 15, 2026 payer document Premera Blue Cross Testing for Vector-Borne Infections listed, no stance Feb 6, 2026 payer document
Medicaid fee-for-service AZ: $8.19 (lab), effective Oct 1, 2026 CO: $8.19 (lab_cdl), effective Oct 1, 2025 FL: $5.25 (lab_independent, non-facility), effective Jan 1, 2026 IL: $8.19 (practitioner), effective Apr 1, 2024 IN: $6.96 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020 KS: $8.49 (default, Exempt Physician), effective Jan 1, 1996 KY: $8.19 (lab), effective Jan 1, 2026 LA: $8.15 (lab_radiology), effective Jul 1, 2012 MS: $7.37 (comprehensive), effective Jul 1, 2026 ND: $8.19 (physician), effective Aug 1, 2026 NE: $8.19 (lab), effective Jul 1, 2026 OH: $6.14 (lab), effective Apr 1, 2021 OK: $7.28 (physician, non-facility), effective Jul 1, 2026 VA: $4.63 (medical), effective Jul 1, 2014 VT: $7.99 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $6.55 (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.