86353 CPT® code: payer coverage and prior authorization4 of 4 payer prior-auth lists that name 86353 require prior authorization or set conditions: UnitedHealthcare Community Plan.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| UnitedHealthcare Community Plan | AHCCCS Complete Care (ACC) | AZ | prior auth required | Oct 1, 2026 | Prior authorization requirements for AHCCCS Complete Care (ACC) Medicaid effective October 1, 2026 | |
| UnitedHealthcare Community Plan | ALTCS Developmentally Disabled | AZ | prior auth required | Oct 1, 2026 | Prior authorization requirements for Arizona Developmental Disabilities Effective October 1, 2026 | |
| UnitedHealthcare Community Plan | ALTCS Long Term Care | AZ | prior auth required | Oct 1, 2026 | Prior authorization requirements for Arizona Long Term Care Effective October 1, 2026 | |
| UnitedHealthcare Community Plan | New Mexico Turquoise Care | NM | prior auth required | Oct 1, 2026 | Prior authorization requirements for UnitedHealthcare Community Plan of New Mexico Effective October 1, 2026 |
86353 appears in 13 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna, Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Allergy and Hypersensitivity (0038) | covered if criteria are met | Mar 10, 2026 | payer document |
| Aetna | Complementary and Alternative Medicine (0388) | not covered | Jun 25, 2026 | payer document |
| Aetna | Lyme Disease and other Tick-Borne Diseases (0215) Alpha lipoic acid or “Healing” Detox Drips, testing for other tick-borne diseases from other organisms, antibiotic augmented thermo-eradication (AAT) therapy | not covered | Jul 21, 2026 | payer document |
| Aetna | Recurrent Pregnancy Loss (0348) | not covered | Jun 23, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Immune Cell Function Assay | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Mississippi | Intracellular Micronutrient Analysis | unproven / investigational | payer document | |
| Blue Cross NC | Allergy Skin and Challenge Testing | listed, no stance | Nov 1, 2025 | payer document |
| Blue Cross NC | Diagnosis of Idiopathic Environmental Intolerance AHS - G2056 | listed, no stance | Jan 1, 2026 | payer document |
| Blue Cross NC | Professional Pathology Billing Requirements AHS – R2169 | listed, no stance (range 86000-86999) | Mar 1, 2024 | payer document |
| BlueCross BlueShield of South Carolina | Diagnosis and Management of Idiopathic Environmental Intolerance (i.e., Clinical Ecology) (CAM 267) Code Number | listed, no stance | Jan 1, 2026 | payer document |
| Cigna | Laboratory Testing Services (0604) | not covered | May 15, 2026 | payer document |
| Premera Blue Cross | Diagnosis of Idiopathic Environmental Intolerance | listed, no stance | Feb 6, 2026 | payer document |
| Premera Blue Cross | Intracellular Micronutrient Analysis | listed, no stance | Oct 14, 2025 | payer document |
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.