S8080 ScintimammographyScintimammography (radioimmunoscintigraphy of the breast), unilateral, including supply of radiopharmaceutical
Status I: not valid for Medicare (Medicare uses another code).
5 of 5 payer prior-auth lists that name S8080 require prior authorization or set conditions: Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Texas, Molina Healthcare of Texas.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross and Blue Shield of Illinois | Blue Cross Community MMAI (Medicare-Medicaid Alignment Initiative) | IL | prior auth required | eviCore-managed | Jun 1, 2017 | Procedure Code List, Effective 1/1/2025 |
| 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) |
| Molina Healthcare of Texas | STAR | TX | prior auth required | Feb 19, 2025 | Molina Healthcare of Texas Prior Authorization Annual Review Report (STAR), reviewed 2025-02-19 | |
| Molina Healthcare of Texas | STAR+PLUS | TX | prior auth required | Feb 19, 2025 | Molina Healthcare of Texas Prior Authorization Annual Review Report (STAR+PLUS), reviewed 2025-02-19 | |
| Molina Healthcare of Texas | STAR, STAR+PLUS, STAR Kids, CHIP (Medicaid PA code matrix) | TX | prior auth required | Jul 1, 2026 | Medicaid Behavioral Health and Medical Prior Authorization (PA) Code Matrix (Texas), 2026-Q3 |
S8080 appears in 15 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Shield of California, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Gender Affirming Surgery (0615) | covered if criteria are met | Sep 8, 2026 | payer document |
| Aetna | Tumor Scintigraphy (0168) | not covered | Mar 27, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Scintimammography And Gamma Imaging Of The Breast And Axilla | listed, no stance | payer document | |
| Blue Cross Blue Shield of Massachusetts | Scintimammography Breast-Specific Gamma Imaging (494) | unproven / investigational | payer document | |
| Blue Shield of California | Scintimammography and Gamma Imaging of the Breast and Axilla (6.01.18) | listed, no stance | payer document | |
| UnitedHealthcare | Breast Imaging for Screening and Diagnosing Cancer (CS010.X) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Breast Imaging for Screening and Diagnosing Cancer (2026T0375LL) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Breast Imaging for Screening and Diagnosing Cancer (for Kansas Only) (CS010KS.03) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Breast Imaging for Screening and Diagnosing Cancer (for Kentucky Only) (CS010KY.06) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Breast Imaging for Screening and Diagnosing Cancer (for Nebraska Only) (CS010NE.X) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Breast Imaging for Screening and Diagnosing Cancer (for New Mexico Only) (CS010NM.D) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Breast Imaging for Screening and Diagnosing Cancer (for Ohio Only) (CS010OH.E) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Breast Imaging for Screening and Diagnosing Cancer (for Pennsylvania Only) (CS010PA.V) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Breast Imaging for Screening and Diagnosing Cancer (for Tennessee Only) (CS010TN.W) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Outpatient Radiology Procedures for EviCore Arrangement (for Oxford Only) (RADIOLOGY) Dates of Service | listed, no stance | Sep 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.