88280 CPT® code: payer coverage and prior authorization3 of 3 payer prior-auth lists that name 88280 require prior authorization or set conditions: UnitedHealthcare Community Plan.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| UnitedHealthcare Community Plan | AHCCCS Complete Care (ACC) | AZ | prior auth required | Oct 1, 2026 | Prior authorization requirements for AHCCCS Complete Care (ACC) Medicaid effective October 1, 2026 | |
| UnitedHealthcare Community Plan | ALTCS Developmentally Disabled | AZ | prior auth required | Oct 1, 2026 | Prior authorization requirements for Arizona Developmental Disabilities Effective October 1, 2026 | |
| UnitedHealthcare Community Plan | ALTCS Long Term Care | AZ | prior auth required | Oct 1, 2026 | Prior authorization requirements for Arizona Long Term Care Effective October 1, 2026 |
88280 appears in 10 coverage policies from Aetna, Blue Cross NC, Cigna, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Comparative Genomic Hybridization (CGH) (0787) | listed, no stance | Nov 19, 2025 | payer document |
| Aetna | Growth Hormone (GH) and Growth Hormone Antagonists (0170) | listed, no stance (range 88280-88289) | Jun 26, 2026 | payer document |
| Aetna | Infertility (0327) | covered if criteria are met | Jul 16, 2026 | payer document |
| Aetna | Invasive Prenatal Diagnosis of Genetic Diseases (0358) | covered if criteria are met (range 88271-88299) | May 22, 2026 | payer document |
| Aetna | Recurrent Pregnancy Loss (0348) | covered if criteria are met (range 88280-88289) | Jun 23, 2026 | payer document |
| Aetna | Tourette's Syndrome (0480) | not covered (range 88280-88289) | Jul 24, 2026 | payer document |
| Blue Cross NC | General Genetic Testing, Somatic Disorders AHS - M2146 | listed, no stance | Jan 1, 2026 | payer document |
| Blue Cross NC | Prenatal Testing for Fetal Aneuploidy AHS - G2055 | listed, no stance | Jan 1, 2026 | payer document |
| Cigna | Infertility Services (0089) | covered if criteria are met | Jun 15, 2025 | payer document |
| UnitedHealthcare | Infertility Diagnosis, Treatment, and Fertility Preservation (2026T0270NN) | listed, no stance | Jun 1, 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.