Payer policies › CPT 8717287172 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 87172 Payer coverage policies that name 87172 87172 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 87003-87999) Mar 1, 2024 payer document Cigna Laboratory Testing Services (0604) not covered May 15, 2026 payer document
Medicaid fee-for-service AZ: $4.27 (lab), effective Oct 1, 2026 CO: $4.27 (lab_cdl), effective Oct 1, 2025 IL: $4.15 (practitioner), effective Apr 1, 2024 IN: $3.63 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020 KS: $3.20 (default, Exempt Physician), effective Jul 1, 2023 KY: $4.27 (lab), effective Jan 1, 2026 LA: $4.27 (lab_radiology), effective Jan 1, 2020 MS: $3.84 (comprehensive), effective Jul 1, 2026 ND: $4.27 (physician), effective Aug 1, 2026 NE: $4.27 (lab), effective Jul 1, 2026 NY: $2.02 (lab), effective Aug 1, 2026 OH: $3.20 (lab), effective Apr 1, 2021 OK: $3.80 (physician, non-facility), effective Jul 1, 2026 VA: $4.27 (medical), effective Jan 1, 2020 VT: $4.16 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $3.42 (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.