Payer policies › CPT 8697586975 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 86975 Payer coverage policies that name 86975 86975 appears in 3 coverage policies from Aetna, Blue Cross NC, Cigna.
Payer Policy Role in policy Reviewed Document Aetna Parenteral Immunoglobulins (0206) listed, no stance (range 86975-86978) Oct 8, 2026 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 Prior authorization required or conditional in VT.
AZ: $22.79 (lab), effective Oct 1, 2026 CO: $27.76 (chp_plus, non-facility), effective Jul 1, 2026 FL: $5.85 (lab_independent, non-facility), effective Jan 1, 2026 IL: $16.40 (practitioner), effective Mar 1, 2013 IN: $33.18 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026 KS: $176.70 (default, Exempt Physician), effective Jul 1, 2023 LA: $2.00 (lab_radiology), effective Jul 1, 2012 MS: $295.21 (comprehensive), effective Jul 1, 2026 ND: $0.00 (physician), effective Aug 1, 2026 NE: $91.97 (physician, non-facility), effective Jul 1, 2026 OH: $14.43 (lab), effective Jan 1, 2018 OK: $0.00 (physician, non-facility), effective Jul 1, 2026 VA: $5.00 (medical), effective Jan 1, 1993 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WY: $197.56 (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.