86922 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 86922

Payer coverage policies that name 86922

86922 appears in 8 coverage policies from Aetna, Blue Cross NC, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaHematopoietic Cell Transplantation for Aplastic Anemia and other Bone Marrow Failure Syndromes (0627)listed, no stance (range 86920-86923)Sep 23, 2026payer document
AetnaHematopoietic Cell Transplantation for Autoimmune Diseases and Miscellaneous Indications (0606)listed, no stance (range 86920-86923)Sep 18, 2026payer document
AetnaHematopoietic Cell Transplantation for Multiple Myeloma (0497)listed, no stance (range 86920-86923)Aug 5, 2026payer document
AetnaHematopoietic Cell Transplantation for Selected Leukemias (0640)listed, no stance (range 86920-86923)Sep 11, 2026payer document
AetnaHematopoietic Cell Transplantation for Thalassemia Major and Sickle Cell Anemia (0626)listed, no stance (range 86920-86923)Sep 18, 2026payer document
AetnaStem Cells for Hematopoietic Cell Transplant (0190)covered if criteria are metMar 27, 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

  • AZ: $26.42 (lab), effective Oct 1, 2026
  • CO: $16.13 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $36.13 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $9.40 (practitioner), effective Jul 1, 2026
  • IN: $22.13 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026
  • KS: $97.10 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $31.00 (lab), effective Jan 1, 2026
  • LA: $35.35 (lab_radiology), effective Jul 1, 2012
  • MS: $129.38 (comprehensive), effective Jul 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • NE: $41.29 (physician, non-facility), effective Jul 1, 2026
  • OH: $21.45 (lab), effective Jan 1, 2018
  • OK: $42.14 (physician, non-facility), effective Jul 1, 2026
  • TX: $11.11 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), non-facility), effective Sep 1, 2025
  • VA: $8.60 (medical), effective Jan 1, 1993
  • VT: $132.29 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $75.35 (outpatient_hospital_apc, Ambulatory Surgical Centers), 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.