CPT 86332 is referenced in 2 tracked payer policy changes from Capital Blue Cross and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 86332 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Capital Blue Cross updated its medical policies, with most changes effective July 1, 2026 unless otherwise indicated. Prior authorization for Loargys and Exdensur now applies to J3590 and C9399 starting July 1, 2026, and the PA requirement for Exdensur moved from a 6/1 date to 7/1. Many revised medical injectable policies take effect August 1, 2026, and several policies remove procedure codes that will now be managed by EviCore.
Aetna considers outpatient IV antibiotic therapy medically necessary for Lyme disease only when the clinical presentation is compatible with the disease and supported by two-tier serologic testing. Once Lyme disease is definitively diagnosed, an initial 4-week course of outpatient IV antibiotic therapy is medically necessary for persistent Lyme arthritis after failing a 4-week course of oral antibiotics, for moderate-to-severe cardiac or neurologic involvement, and for specified cases in pregnant women, and one repeat 4-week course is medically necessary with objective evidence of relapse, progression of organ damage, or a new focus or type of organ damage. Aetna considers IV antibiotic therapy for early Lyme disease, additional antibiotic therapy for post-treatment persistently fatigued patients, and a range of listed tests and treatments experimental, investigational, or unproven.
Watch 86332
Get one email when a payer policy names 86332, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.
See every payer rule for 86332
Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 86332 in one place.
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.