88375 CPT® code: payer coverage and prior authorization1 of 1 payer prior-auth lists that name 88375 require prior authorization or set conditions: Rocky Mountain Health Plans.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Rocky Mountain Health Plans | Rocky Mountain Medicare Advantage D-SNP | CO | prior auth required | Feb 1, 2025 | Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025 |
88375 appears in 15 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Blue Shield of California, BlueCross BlueShield of South Carolina, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Cervical Cancer Screening and Diagnosis (0443) | not covered (range 88367-88377) | Jul 22, 2026 | payer document |
| Aetna | Trastuzumab Products (0313) | listed, no stance (range 88367-88377) | Jun 8, 2026 | payer document |
| Aetna | Tumor Markers (0352) | listed, no stance (range 88367-88377) | Aug 25, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Confocal Laser Endomicroscopy | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Confocal Laser Endomicroscopy | not covered | Oct 1, 2025 | payer document |
| Blue Cross Blue Shield of Massachusetts | Confocal Laser endomicroscopy (618) | unproven / investigational | payer document | |
| Blue Cross NC | Confocal Laser Endomicroscopy | listed, no stance | Mar 1, 2026 | payer document |
| Blue Cross NC | Professional Pathology Billing Requirements AHS – R2169 | listed, no stance (range 88300-88399) | Mar 1, 2024 | payer document |
| Blue Shield of California | | Confocal Laser Endomicroscopy (2.01.87) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Confocal Laser Endomicroscopy (CAM 20187) | listed, no stance | Jun 1, 2026 | payer document |
| Cigna | Laboratory Testing Services (0604) | not covered | May 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Confocal Laser Endomicroscopy (CLE) (MED201.038) | listed, no stance | Jul 15, 2025 | payer document |
| Regence | Confocal Laser Endomicroscopy (Medicine 151) | listed, no stance | Sep 1, 2025 | payer document |
| Regence | In Vivo Analysis of Colorectal Lesions (Medicine 104) | listed, no stance | Dec 1, 2025 | payer document |
| UnitedHealthcare | Omnibus Codes (MMP107.09) analysis (when used to report PreTrm) | necessary; refer to the | listed, no stance | Jun 1, 2026 | payer document |
Prior authorization required or conditional in IN.
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.