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PAYER POLICY CHANGES

85396 Insurance Policy Changes

CPT 85396, in plain terms, covers Whole blood clotting and clot-breakdown assay such as viscoelastic testing, which may also include drug additives, with physician interpretation and written report, billed once per day. No tracked policy changes reference CPT 85396 yet. New payer updates are added daily, so check back soon or create a free alert to be notified the moment a change affects this code.

Official descriptor: CPT 85396 on AAPC

No policies yet

No tracked policy changes match this filter yet. New policies are added daily.

Watch 85396

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REFERENCE DATA

Payers with rules1
Payers requiring prior auth1
  • Anthem BCBS · Effective September 1, 2026

    Prior authorization required in some cases

    Virginia Local Precertification/Prior Authorization List (HMO & EPO)

FREQUENTLY ASKED QUESTIONS

Does Anthem BCBS require prior authorization for 85396?

Anthem BCBS lists 85396 on Virginia Local Precertification/Prior Authorization List (HMO & EPO) for commercial plans, with conditions (list dated September 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 85396?

No policy changes affecting CPT 85396 have been tracked yet. Check back as coverage expands.

Which payers have updated policy for CPT 85396?

No payer-specific updates have been tracked for CPT 85396 yet.

How do I get notified when CPT 85396 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 85396. 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 85396?

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 85396

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 85396 in one place.

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