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PAYER POLICY CHANGES

78458 Insurance Policy Changes

CPT 78458, in plain terms, covers A scan to check both legs for blood clots in the veins. CPT 78458 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 78458 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 78458 on AAPC

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REFERENCE DATA

Payers with rules11
Payers requiring prior auth11
  • 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 78458?

BCBS Illinois lists 78458 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 78458?

BCBS Michigan lists 78458 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 78458?

BCBS Montana lists 78458 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 78458?

BCBS New Mexico lists 78458 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 78458?

BCBS Oklahoma lists 78458 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 78458?

There are 5 tracked policy changes affecting CPT 78458, 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 78458?

Payers that have issued tracked updates for CPT 78458 include: Highmark, Blue Cross Blue Shield of Rhode Island, Aetna.

How do I get notified when CPT 78458 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 78458. 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 78458?

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 78458

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 78458 in one place.

See every payer rule

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