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PAYER POLICY CHANGES

86318 Insurance Policy Changes

CPT 86318 is referenced in 2 tracked payer policy changes from Blue Cross NC and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 86318 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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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 86318?

Anthem BCBS lists 86318 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 86318?

There are 2 tracked policy changes affecting CPT 86318, including updates from Blue Cross NC, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 86318?

Payers that have issued tracked updates for CPT 86318 include: Blue Cross NC, Aetna.

How do I get notified when CPT 86318 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 86318. 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 86318?

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 86318

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 86318 in one place.

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