86835 CPT® code: payer coverage and prior authorization86835 appears in 26 coverage policies from Aetna, Blue Cross & Blue Shield of Rhode Island, Blue Cross NC, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Allogeneic Processed Thymus Tissue–agdc (Rethymic) (1055) | listed, no stance (range 86828-86835) | Dec 23, 2025 | payer document |
| Aetna | Celiac Disease Laboratory Testing (0561) | covered if criteria are met (range 86834-86835) | Aug 3, 2026 | payer document |
| Aetna | Invasive Prenatal Diagnosis of Genetic Diseases (0358) | not covered (range 86834-86835) | May 22, 2026 | payer document |
| Aetna | Polymerase Chain Reaction Testing: Selected Indications (0650) | covered if criteria are met (range 86828-86835) | Sep 10, 2026 | payer document |
| Aetna | Recurrent Pregnancy Loss (0348) | covered if criteria are met (range 86834-86835) | Jun 23, 2026 | payer document |
| Blue Cross & Blue Shield of Rhode Island | Human Leukocyte Antigen (HLA) Testing Mandate MEDICAL COVERAGE POLICY | 2 | listed, no stance | Jun 1, 2025 | 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 |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms (SUR703.032) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, | listed, no stance | May 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Acute Lymphoblastic Leukemia (SUR703.043) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, 38212, | listed, no stance | Sep 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Acute Myeloid Leukemia (SUR703.037) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, 38212, | listed, no stance | Aug 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Autoimmune Diseases (SUR703.036) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, | listed, no stance | Jun 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Breast Cancer (SUR703.038) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, | listed, no stance | May 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Central Nervous System Embryonal Tumors and Ependymoma (SUR703.039) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, | listed, no stance | Sep 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL) (SUR703.029) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, 38212, | listed, no stance | May 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Chronic Myeloid Leukemia (SUR703.041) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, 38212, | listed, no stance | Jun 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Epithelial Ovarian Cancer (SUR703.034) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, | listed, no stance | May 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Genetic Diseases and Acquired Anemias (SUR703.033) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, | listed, no stance | Jun 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Hodgkin Lymphoma (SUR703.040) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, 38212, | listed, no stance | Apr 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Miscellaneous Solid Tumors in Adults (SUR703.035) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, 38212, | listed, no stance | Aug 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Non-Hodgkin Lymphomas (SUR703.031) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, 38212, | listed, no stance | May 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma and POEMS Syndrome (SUR703.030) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, 38212, | listed, no stance | May 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Primary Systemic Amyloidosis (SUR703.046) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, 38212, | listed, no stance | Jun 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Solid Tumors of Childhood (SUR703.044) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, | listed, no stance | Jun 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation for Waldenstrom Macroglobulinemia (SUR703.050) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, | listed, no stance | Jan 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Hematopoietic Cell Transplantation in the Treatment of Germ Cell Tumors (SUR703.045) CPT Codes 36511, 38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, | listed, no stance | Jun 15, 2026 | payer document |
Prior authorization required or conditional in WA, WV.
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.