87451 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 87451

Payer coverage policies that name 87451

87451 appears in 2 coverage policies from Blue Cross NC, Cigna.

PayerPolicyRole in policyReviewedDocument
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 87003-87999)Mar 1, 2024payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $10.51 (lab), effective Oct 1, 2026
  • CO: $10.51 (lab_cdl), effective Oct 1, 2025
  • FL: $5.90 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $9.73 (practitioner), effective Mar 1, 2013
  • IN: $8.93 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $8.45 (default, Exempt Physician), effective Jul 17, 2001
  • KY: $10.51 (lab), effective Jan 1, 2026
  • LA: $8.93 (lab_radiology), effective Jul 1, 2025
  • MS: $9.46 (comprehensive), effective Jul 1, 2026
  • ND: $10.51 (physician), effective Aug 1, 2026
  • NE: $10.51 (lab), effective Jul 1, 2026
  • OH: $7.88 (lab), effective Apr 1, 2021
  • OK: $9.35 (physician, non-facility), effective Jul 1, 2026
  • VA: $3.99 (medical), effective Jul 1, 2014
  • VT: $10.25 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $8.41 (physician, facility), 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.