86360 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 86360

Payer coverage policies that name 86360

86360 appears in 13 coverage policies from Aetna, Blue Cross NC, Cigna, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaAllergy and Hypersensitivity (0038)not coveredMar 10, 2026payer document
AetnaAllogeneic Processed Thymus Tissue–agdc (Rethymic) (1055)listed, no stanceDec 23, 2025payer document
AetnaBrain Natriuretic Peptide Testing (0618)listed, no stanceSep 29, 2026payer document
AetnaFlow Cytometry, Ektacytometry, DNA Ploidy, and S-phase Fraction (0351)covered if criteria are metMay 21, 2026payer document
AetnaHematopoietic Cell Transplantation for Thalassemia Major and Sickle Cell Anemia (0626)not coveredSep 18, 2026payer document
AetnaLyme 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 coveredJul 21, 2026payer document
AetnaLysosomal Storage Disorder Treatments (0442)listed, no stanceJul 8, 2026payer document
AetnaMyalgic Encephalomyelitis - Chronic Fatigue Syndrome (ME/CSF) (0369)not coveredMay 20, 2026payer document
Blue Cross NCFlow Cytometry AHS - F2019listed, no stanceApr 1, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 86000-86999)Mar 1, 2024payer document
CignaFlow Cytometry (0538)covered if criteria are metSep 15, 2026payer document
CignaInfertility Services (0089)unproven / investigationalJun 15, 2025payer document
Premera Blue CrossFlow Cytometrylisted, no stanceOct 14, 2025payer document

Medicaid fee-for-service

  • AZ: $46.98 (lab), effective Oct 1, 2026
  • CO: $46.98 (lab_cdl), effective Oct 1, 2025
  • FL: $9.58 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $32.89 (practitioner), effective Apr 1, 2024
  • IN: $39.93 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $29.95 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $46.98 (lab), effective Jan 1, 2026
  • LA: $40.06 (lab_radiology), effective Jul 1, 2012
  • MS: $42.28 (comprehensive), effective Jul 1, 2026
  • ND: $46.98 (physician), effective Aug 1, 2026
  • NE: $46.98 (lab), effective Jul 1, 2026
  • NY: $46.98 (lab), effective Aug 1, 2026
  • OH: $35.23 (lab), effective Apr 1, 2021
  • OK: $41.79 (physician, non-facility), effective Jul 1, 2026
  • VA: $25.64 (medical), effective Jan 1, 2016
  • VT: $45.81 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $37.58 (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.