Payer policies › CPT 8640386403 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 86403 Payer coverage policies that name 86403 86403 appears in 3 coverage policies from Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Cigna.
Payer Policy Role in policy Reviewed Document Blue Cross & Blue Shield of Mississippi Fecal Analysis In The Diagnosis Of Intestinal Dysbiosis unproven / investigational payer document Blue Cross NC Professional Pathology Billing Requirements AHS – R2169 listed, no stance (range 86000-86999) Mar 1, 2024 payer document Cigna Laboratory Testing Services (0604) not covered May 15, 2026 payer document
Medicaid fee-for-service AZ: $11.54 (lab), effective Oct 1, 2026 CO: $11.54 (lab_cdl), effective Oct 1, 2025 FL: $6.23 (lab_independent, non-facility), effective Jan 1, 2026 IL: $16.16 (practitioner), effective Apr 1, 2024 IN: $9.81 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2019 KS: $8.65 (default, Exempt Physician), effective Jul 1, 2023 KY: $11.54 (lab), effective Jan 1, 2026 LA: $10.15 (lab_radiology), effective Jul 1, 2012 MS: $10.39 (comprehensive), effective Jul 1, 2026 ND: $11.54 (physician), effective Aug 1, 2026 NE: $11.54 (lab), effective Jul 1, 2026 NY: $3.79 (lab), effective Aug 1, 2026 OH: $8.66 (lab), effective Apr 1, 2019 OK: $10.26 (physician, non-facility), effective Jul 1, 2026 VA: $8.57 (medical), effective Jul 1, 2014 VT: $11.25 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $9.23 (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.