87480 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 87480

Payer coverage policies that name 87480

87480 appears in 11 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, BlueCross BlueShield of South Carolina, Centene, Cigna, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaDiagnosis of Vaginitis (0643)covered if criteria are metSep 25, 2026payer document
AetnaMyalgic Encephalomyelitis - Chronic Fatigue Syndrome (ME/CSF) (0369)not coveredMay 20, 2026payer document
Blue Cross & Blue Shield of MississippiIdentification Of Microorganisms Using Nucleic Acid Probescovered if criteria are metpayer document
Blue Cross Blue Shield of MassachusettsIdentification of Microorganisms (555)listed, no stancepayer document
Blue Cross NCDiagnosis of Vaginitis AHS - M2057listed, no stanceApr 1, 2026payer document
Blue Cross NCOnychomycosis Testing AHS - M2172listed, no stanceApr 1, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 87003-87999)Mar 1, 2024payer document
BlueCross BlueShield of South CarolinaOnychomycosis Testing (CAM 243)listed, no stanceApr 1, 2026payer document
CenteneTesting for Select Genitourinary Conditions (CP.MP.97)covered if criteria are metpayer document
CignaNucleic Acid Pathogen Testing (0530)covered if criteria are metAug 15, 2026payer document
Premera Blue CrossOnychomycosis Testinglisted, no stanceOct 14, 2025payer document

Medicaid fee-for-service

  • AZ: $20.05 (lab), effective Oct 1, 2026
  • CO: $20.05 (lab_cdl), effective Oct 1, 2025
  • FL: $10.83 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $20.05 (practitioner), effective Apr 1, 2024
  • IN: $17.04 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $12.78 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $20.05 (lab), effective Jan 1, 2026
  • LA: $20.05 (lab_radiology), effective Jan 1, 2020
  • MS: $18.05 (comprehensive), effective Jul 1, 2026
  • ND: $20.05 (physician), effective Aug 1, 2026
  • NE: $20.05 (lab), effective Jul 1, 2026
  • NY: $14.09 (lab), effective Aug 1, 2026
  • OH: $15.04 (lab), effective Apr 1, 2021
  • OK: $17.83 (physician, non-facility), effective Jul 1, 2026
  • TX: $18.65 (hhsc_family_planning_program, Hhsc Family Planning Program), effective Mar 1, 2021
  • VA: $8.89 (medical), effective Jan 1, 2016
  • VT: $19.55 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $16.04 (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.