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PAYER POLICY CHANGES

75580 Insurance Policy Changes

CPT 75580, in plain terms, covers Software based estimate of coronary fractional flow reserve calculated from existing coronary CT angiography data, with physician review and report. CPT 75580 is referenced in 11 tracked payer policy changes from Blue Cross Blue Shield of Nebraska, Aetna Better Health of Virginia, and 5 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 75580 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 75580 on AAPC

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REFERENCE DATA

Payers with rules11
Payers requiring prior auth11
  • Aetna · Effective November 1, 2026

    Prior authorization required

    Participating provider precertification list for Aetna

  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

    Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)

  • Excellus BlueCross BlueShield · Effective October 1, 2026

    Prior authorization required

    Excellus BCBS utilization management standard clinical review preauthorization list

FREQUENTLY ASKED QUESTIONS

Does Aetna require prior authorization for 75580?

Aetna lists 75580 on Participating provider precertification list for Aetna for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does Anthem BCBS require prior authorization for 75580?

Anthem BCBS lists 75580 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does BCBS Illinois require prior authorization for 75580?

BCBS Illinois lists 75580 on Utilization Management Process for medicare advantage plans (list dated October 1, 2026). Verify with the payer before scheduling.

Does BCBS New Mexico require prior authorization for 75580?

BCBS New Mexico lists 75580 on Medicare Advantage Prior Authorization Procedure Code List for medicare advantage plans (list dated October 1, 2026). Verify with the payer before scheduling.

Does BCBS Texas require prior authorization for 75580?

BCBS Texas lists 75580 on Medicare Advantage Prior Authorization Procedure Code List for medicare advantage plans (list dated October 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 75580?

There are 11 tracked policy changes affecting CPT 75580, including updates from Blue Cross Blue Shield of Nebraska, Aetna Better Health of Virginia, Excellus BlueCross BlueShield. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 75580?

Payers that have issued tracked updates for CPT 75580 include: Blue Cross Blue Shield of Nebraska, Aetna Better Health of Virginia, Excellus BlueCross BlueShield, Humana, Aetna, Blue Cross & Blue Shield of Mississippi, Premera Blue Cross.

How do I get notified when CPT 75580 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 75580. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for CPT 75580?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

See every payer rule for 75580

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 75580 in one place.

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