87580 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 87580

Payer coverage policies that name 87580

87580 appears in 7 coverage policies from Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
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 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
Premera Blue CrossIdentification of Microorganisms using Nucleic Acid Probeslisted, no stanceFeb 6, 2026payer 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: $7.50 (default, Exempt Physician), effective Jan 1, 1998
  • 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
  • OH: $15.04 (lab), effective Apr 1, 2021
  • VA: $20.05 (medical), effective Jan 1, 2020
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $16.04 (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.