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PAYER POLICY CHANGES

78457 Insurance Policy Changes

CPT 78457, in plain terms, covers Nuclear venography of one side to look for blood clots in the veins of a limb. CPT 78457 is referenced in 5 tracked payer policy changes from Highmark, Blue Cross Blue Shield of Rhode Island, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 78457 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 78457 on AAPC

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REFERENCE DATA

Payers with rules9
Payers requiring prior auth9
  • 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)

  • BCBS Illinois · Effective October 1, 2026

    Prior authorization required in some cases

    Blue Cross Community Health Plans (Illinois Medicaid) Prior Authorization Code List

  • CountyCare Health Plan · Effective April 23, 2026

    Prior authorization required

    CountyCare Prior Authorization Look-Up Tool (All Codes)

FREQUENTLY ASKED QUESTIONS

Does BCBS Illinois require prior authorization for 78457?

BCBS Illinois lists 78457 on 2026 Commercial Outpatient Medical Surgical Prior Authorization Codes for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for 78457?

BCBS Michigan lists 78457 on BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines) for commercial plans, with conditions (list dated October 13, 2026). Verify with the payer before scheduling.

Does BCBS Montana require prior authorization for 78457?

BCBS Montana lists 78457 on 2026 Commercial Medical Surgical Prior Authorization Codes for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

Does BCBS New Mexico require prior authorization for 78457?

BCBS New Mexico lists 78457 on 2026 Commercial Outpatient Medical Surgical ASO Medical Surgical Procedure Code List for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

Does BCBS Oklahoma require prior authorization for 78457?

BCBS Oklahoma lists 78457 on 2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 78457?

There are 5 tracked policy changes affecting CPT 78457, including updates from Highmark, Blue Cross Blue Shield of Rhode Island, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 78457?

Payers that have issued tracked updates for CPT 78457 include: Highmark, Blue Cross Blue Shield of Rhode Island, Aetna.

How do I get notified when CPT 78457 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 78457. 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 78457?

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 78457

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 78457 in one place.

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