86366 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 86366

Payer coverage policies that name 86366

86366 appears in 5 coverage policies from Aetna, Blue Cross NC, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaAntibody Tests for Neurologic Diseases (0340)covered if criteria are metJul 8, 2026payer document
AetnaInebilizumab-cdon (Uplizna) (0975)listed, no stanceAug 11, 2026payer document
AetnaNipocalimab-aahu (Imaavy) (1083)listed, no stanceAug 11, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 86000-86999)Mar 1, 2024payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN, VA.

  • AZ: $18.40 (lab), effective Oct 1, 2026
  • CO: $15.01 (lab_cdl), effective Apr 1, 2026
  • IL: $13.25 (practitioner), effective Jan 1, 2024
  • KS: $11.73 (default, Exempt Physician), effective Jan 1, 2024
  • KY: $18.40 (lab), effective Jan 1, 2026
  • LA: $15.64 (lab_radiology), effective Jul 1, 2025
  • MS: $16.56 (comprehensive), effective Jul 1, 2026
  • ND: $18.40 (physician), effective Aug 1, 2026
  • NY: $11.40 (lab), effective Aug 1, 2026
  • OH: $13.80 (lab), effective Jul 1, 2024
  • OK: $16.37 (physician, non-facility), effective Jul 1, 2026
  • VA: $16.19 (medical), effective Jan 1, 2024
  • VT: $17.94 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $14.72 (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.