Q0486 Mon cable elec/pneum vad repMonitor control cable for use with electric/pneumatic ventricular assist device, replacement only
Status E: excluded from the PFS by regulation.
4 of 4 payer prior-auth lists that name Q0486 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Blue Cross and Blue Shield of Texas.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross Blue Shield of Arizona (AZ Blue) | AZ Blue-administered Medicare Advantage (M2K) | AZ | prior auth required | Sep 1, 2026 | AZ Blue Medicare Advantage Prior Authorization Requirements Code List (Effective 09/01/2026) | |
| Blue Cross Blue Shield of Arizona (AZ Blue) | Standard PA code list (most commercial plans) | AZ | prior auth required | Gold-card eligible | Sep 1, 2026 | AZ Blue Standard Prior Authorization Requirements Code List (09/01/2026) |
| Blue Cross Blue Shield of Arizona (AZ Blue) | State of Arizona employee group (SYD, S3Z) | AZ | prior auth required | Gold-card eligible | Sep 1, 2026 | State of Arizona Group Prior Authorization Requirements Code List (09/01/2026) |
| Blue Cross and Blue Shield of Texas | Texas PA exemption (gold card), outpatient, fully insured | TX | prior auth required | Gold-card exemption available | Jul 1, 2026 | BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range) |
Q0486 appears in 7 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Shield of California, BlueCross BlueShield of South Carolina, Centene, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Regence.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Ventricular Assist Devices (0654) | covered if criteria are met | Sep 10, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Total Artificial Hearts And Implantable Ventricular Assist Devices | covered if criteria are met | payer document | |
| Blue Shield of California | Total Artificial Hearts and Implantable Ventricular Assist Devices (7.03.11) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Total Artificial Hearts and Implantable Ventricular Assist Devices (CAM 70311) 33991 | ; both arterial and venous access, with transseptal puncture | listed, no stance (range Q0478-Q0509) | Mar 1, 2026 | payer document |
| Centene | Ventricular Assist Devices (CP.MP.46) | covered if criteria are met | Nov 1, 2025 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Ventricular Assist Devices and Total Artificial Hearts (SUR707.017) HCPCS Codes L8698, Q0477, Q0478, Q0479, Q0480, Q0481, Q0482, Q0483, Q0484, Q0485, | listed, no stance | Jan 1, 2026 | payer document |
| Regence | Ventricular Assist Devices and Total Artificial Hearts (Surgery 52) | listed, no stance (range Q0477-Q0509) | Jan 1, 2026 | payer document |
Prior authorization required or conditional in IN, OH, WA.
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.