Start free
PAYER POLICY CHANGES

77046 Insurance Policy Changes

CPT 77046, in plain terms, covers MRI of a single breast performed without any contrast injection, used to evaluate breast tissue or check out a suspected abnormality on one side only. CPT 77046 is referenced in 18 tracked payer policy changes from Blue Cross Blue Shield of Vermont, Blue Cross Blue Shield of North Dakota, and 11 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 77046 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 77046 on AAPC

Watch 77046

Get one email when a payer policy names 77046, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

No account needed. We send a confirmation link first, and every email has a one-click stop link.

REFERENCE DATA

Payers with rules21
Payers requiring prior auth21
  • Aetna · Effective November 1, 2026

    Prior authorization required in some cases

    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)

  • BCBS Michigan · Effective October 13, 2026

    Prior authorization required in some cases

    BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines)

FREQUENTLY ASKED QUESTIONS

Does Aetna require prior authorization for 77046?

Aetna lists 77046 on Participating provider precertification list for Aetna for commercial plans, with conditions (list dated November 1, 2026). Verify with the payer before scheduling.

Does AmeriHealth Caritas require prior authorization for 77046?

AmeriHealth Caritas lists 77046 on AmeriHealth Caritas North Carolina Utilization Review Matrix 2025 for medicaid managed plans (list dated January 1, 2025). Verify with the payer before scheduling.

Does Anthem BCBS require prior authorization for 77046?

Anthem BCBS lists 77046 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 Arizona Complete Health require prior authorization for 77046?

Arizona Complete Health lists 77046 on Arizona Complete Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does BCBS Arizona require prior authorization for 77046?

BCBS Arizona lists 77046 on AZ Blue Standard Prior Authorization Requirements Code List (Updated 10/01/2026) for commercial plans, with conditions (list dated October 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 77046?

There are 18 tracked policy changes affecting CPT 77046, including updates from Blue Cross Blue Shield of Vermont, Blue Cross Blue Shield of North Dakota, Wisconsin Medicaid (ForwardHealth). Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 77046?

Payers that have issued tracked updates for CPT 77046 include: Blue Cross Blue Shield of Vermont, Blue Cross Blue Shield of North Dakota, Wisconsin Medicaid (ForwardHealth), Humana, Sentara Health Plans, Capital Blue Cross, HealthPartners, Premera Blue Cross, Blue Cross & Blue Shield of Mississippi, Texas Medicaid, Aetna, NY Medicaid, Blue Cross Blue Shield of Rhode Island.

How do I get notified when CPT 77046 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 77046. 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 77046?

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 77046

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 77046 in one place.

See every payer rule

RELATED

All billing codesJ3590C9399J3490992159921399202

Get alerts for changes like this

Save a search and get email alerts when a new policy change matches your filters: daily or weekly, your choice, on every plan.

Create a free alertHow Policy Monitoring works