87493 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 87493

Payer coverage policies that name 87493

87493 appears in 9 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaPolymerase Chain Reaction Testing: Selected Indications (0650)covered if criteria are metSep 10, 2026payer document
Blue Cross & Blue Shield of MississippiGastrointestinal Gi Functionhealth Panel (L.2.04.407)unproven / investigationalpayer 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 NCFecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing AHS - G2060listed, no stanceOct 1, 2025payer document
Blue Cross NCIdentification of Microorganisms using Nucleic Acid Probes AHS – M2097listed, no stanceJul 1, 2025payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 87003-87999)Mar 1, 2024payer document
BlueCross BlueShield of South CarolinaIdentification of Microorganisms Using Nucleic Acid Probes (CAM 303)listed, no stanceJul 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $37.27 (lab), effective Oct 1, 2026
  • CO: $31.05 (lab_cdl), effective Jul 1, 2026
  • IL: $37.27 (practitioner), effective Apr 1, 2024
  • IN: $31.68 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $25.70 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $37.27 (lab), effective Jan 1, 2026
  • LA: $34.61 (lab_radiology), effective Jul 1, 2012
  • MS: $33.54 (comprehensive), effective Jul 1, 2026
  • ND: $37.27 (physician), effective Aug 1, 2026
  • NE: $37.27 (lab), effective Jul 1, 2026
  • OH: $27.95 (lab), effective Apr 1, 2021
  • OK: $33.15 (physician, non-facility), effective Jul 1, 2026
  • VA: $12.67 (medical), effective Jan 1, 2015
  • VT: $36.34 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $29.82 (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.