Payer policies › CPT 8697286972 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 86972 Payer coverage policies that name 86972 86972 appears in 2 coverage policies from Blue Cross NC, Cigna.
Payer Policy Role in policy Reviewed 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: $28.93 (lab), effective Oct 1, 2026 CO: $4.44 (chp_plus, non-facility), effective Jul 1, 2026 FL: $4.97 (lab_independent, non-facility), effective Jan 1, 2026 IL: $8.20 (practitioner), effective Jul 1, 2026 IN: $33.18 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026 KS: $97.10 (default, Exempt Physician), effective Jul 1, 2023 LA: $2.00 (lab_radiology), effective Jul 1, 2012 MS: $129.38 (comprehensive), effective Jul 1, 2026 ND: $0.00 (physician), effective Aug 1, 2026 NE: $35.66 (physician, non-facility), effective Jul 1, 2026 OH: $17.56 (lab), effective Jan 1, 2018 OK: $0.00 (physician, non-facility), effective Jul 1, 2026 VT: $0.00 (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.