88104 CPT® code: payer coverage and prior authorization88104 appears in 13 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna, Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Breast Ductal Lavage and Fiberoptic Ductoscopy (0517) | listed, no stance | Aug 5, 2026 | payer document |
| Aetna | Endometrial Cancer Screening, Diagnosis, and Prognosis (0769) | listed, no stance (range 88104-88112) | Oct 3, 2025 | payer document |
| Aetna | Oral and Esophageal Brush Biopsy (0686) | not covered | Oct 15, 2025 | payer document |
| Aetna | Tumor Chemoresistance Assays (0758) | not covered | Dec 2, 2025 | payer document |
| Aetna | Tumor Chemosensitivity Assays (0245) | not covered | Apr 13, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Adjunctive Techniques For Screening Surveillance And Risk Classification Of Barrett Esophagus And Esophageal Dysplasia (A.7.01.167) | unproven / investigational | payer document | |
| Blue Cross NC | Esophageal Pathology Testing AHS - M2171 | listed, no stance | Apr 1, 2026 | payer document |
| Blue Cross NC | In Vitro Chemoresistance and Chemosensitivity Assays AHS- G2100 | listed, no stance | Nov 1, 2025 | payer document |
| Blue Cross NC | Professional Pathology Billing Requirements AHS – R2169 | listed, no stance (range 88104-88199) | Mar 1, 2024 | payer document |
| BlueCross BlueShield of South Carolina | Esophageal Pathology Testing (CAM 242) Number | listed, no stance | Apr 1, 2026 | payer document |
| BlueCross BlueShield of South Carolina | Laboratory/Pathology Services (CAM 472) | listed, no stance | Jan 1, 2026 | payer document |
| Cigna | Wide-Area Transepithelial Tissue Sampling with Computer-Assisted 3D Analysis (WATS3D) (0578) | unproven / investigational | Dec 15, 2025 | payer document |
| Premera Blue Cross | Adjunctive Techniques for Screening, Surveillance, and Risk Classification of Barrett Esophagus and Esophageal Dysplasia (7.01.596) | listed, no stance | Jan 26, 2026 | payer document |
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.