Does Anthem BCBS require prior authorization for 87660?

Anthem BCBS lists 87660 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.

Does CalViva Health require prior authorization for 87660?

CalViva Health lists 87660 on CalViva Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Community Health Plan of Imperial Valley require prior authorization for 87660?

Community Health Plan of Imperial Valley lists 87660 on Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Florida Blue require prior authorization for 87660?

Florida Blue lists 87660 on Prior Authorization List: HMO – Marketplace Qualified Health Plans for exchange plans (list dated March 27, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 87660?

There are 10 tracked policy changes affecting CPT 87660, including updates from Harvard Pilgrim Health Care, Blue Cross NC, Sentara Health Plans. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 87660?

Payers that have issued tracked updates for CPT 87660 include: Harvard Pilgrim Health Care, Blue Cross NC, Sentara Health Plans, BlueCross BlueShield of South Carolina, Aetna, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 87660 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 87660. 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 87660?

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.

PAYER POLICY CHANGES

87660 Insurance Policy Changes

CPT 87660 is referenced in 10 tracked payer policy changes from Harvard Pilgrim Health Care, Blue Cross NC, and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 87660 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Harvard Pilgrim Health Care · Effective Sep 1, 2026High impact
Laboratory Payment Policies: Sept. 1, 2026 updates
Point32Health is implementing multiple CPT code additions and removals across six laboratory payment policies effective September 1, 2026. Billing teams must update coding systems to add new codes (0522U, 83876, 87140, 87270, 87285, 87320, 87494, 87660, 87810, 86141) and remove obsolete codes (0052U, 0308U, 0309U, 0415U, 0541U, 86704, 86706, 87340, G0499, 0455U, 0463U) across autoimmune rheumatic disease, cardiovascular, colorectal, STI, and pancreatic testing policies.
Blue Cross NC · Effective Aug 5, 2026High impact
Medical Policy Updates August 5, 2026
Blue Cross NC issued a comprehensive medical policy update effective August 5, 2026, affecting 11 clinical policies including allergen testing, cardiovascular risk assessment, sexually transmitted infection testing, and colorectal cancer screening. Multiple billing codes were added, removed, or modified across these policies, requiring immediate system updates and billing team training to ensure accurate claim submission and avoid denials.
Sentara Health Plans · Effective Aug 1, 2026High impact
Medical and Clinical Policy Updates - Effective August 1, 2026
Sentara Health Plans updated its medical policies effective August 1, 2026, and most of the changes apply to Commercial and Medicaid products. The main coverage changes narrow when several lab and genetic tests are covered, including percent free PSA as a first-line prostate screening test, C-reactive protein for cardiovascular disease risk assessment, serum micronutrient testing as a general screen, and HIV antibody tests that do not provide rapid results and do not include antigen testing. The update also archives Medical 128 (apheresis) for Commercial and Medicaid, archives BH 27 (Sensory-Weighted Vest) for Commercial, and adds or removes several CPT and PLA codes.
Harvard Pilgrim Health Care · Effective Jun 1, 2026High impact
Laboratory Payment Policies: June 1, 2026 updates
Point32Health (Harvard Pilgrim) is implementing extensive CPT code changes across multiple laboratory policies effective June 1, 2026, including removing 23 codes and adding 24 new codes across 11 different lab testing categories. A new prenatal testing policy for fetal aneuploidy is also being introduced.
Blue Cross NC · Effective Feb 11, 2026High impact
Medical Policy Update February 11, 2026
Blue Cross NC updated multiple medical policies effective February 11, 2026, including changes to coverage criteria for STI testing, diabetes testing code additions, cervical cancer screening restrictions, and vaginitis testing limits. Several CPT codes were removed from covered services while new codes were added for specific conditions.
BlueCross BlueShield of South Carolina · Effective Nov 1, 2025High impact
2025 November Medical Policy Updates
BlueCross BlueShield of South Carolina and BlueChoice HealthPlan released 33 medical policy updates and revisions effective November 2025. Key changes include: new psychological/neuropsychological testing policy (CAM 397), extended lumbar fusion revision surgery timeline (9-12 months vs 6-12 months), expanded HIV testing coverage with PrEP criteria, negative pressure wound therapy trial period extended from 14 to 30 days, multiple CPT code additions/removals in sexual health and infectious disease testing, and new minimal residual disease coverage for diffuse large B-cell lymphoma. Billing teams must immediately update claim submission rules, prior authorization triggers, and CPT code billing matrices across multiple service lines.
Aetna · Identified Oct 1, 2026Medium impact
Diagnosis of Vaginitis (CPB 0643, reviewed 2026-09-25)
Aetna's vaginitis diagnosis policy (CPB 0643), last reviewed 09/25/2026, considers nucleic acid amplification or DNA probe tests for trichomonas, Candida and Gardnerella medically necessary for members with dysuria or symptoms of vaginitis. It also considers BVBlue sialidase testing, PCR tests for bacterial vaginosis and Candida, and pH and amine testing medically necessary for women with symptoms. Trichomonas screening is considered medically necessary for women with listed risk factors, including HIV-positive women, new or multiple partners, history of sexually transmitted diseases, exchange of sex for payment, injection drug use, or high-prevalence settings. Routine screening of asymptomatic women for Candida and Gardnerella, Pap smears for the diagnosis of Candida vulvovaginitis, the uBiome SmartJane screen and the 27-organism vaginal pathogen panel are experimental, investigational or unproven, and screening asymptomatic pregnant women for bacterial vaginosis is experimental and not covered.
BlueCross BlueShield of South Carolina · Identified Sep 1, 2026Medium impact
2026 June Medical Policy Updates
BlueCross BlueShield of South Carolina updated its June 2026 medical policies, and most of the updates are to laboratory and genetic testing policies. The updates add CPT codes such as 0077U, 95004, 81406 and 87626, and remove codes such as 82607, 84999 and 86689. CAM 270 adds a not medically necessary statement on serum micronutrient testing for general screening of nutritional disorders, and CAM 777 Sympathetic Nerve Blocks is a new policy.
Aetna · Identified Aug 14, 2026Medium impact
Diagnosis of Vaginitis (CPB 0643, reviewed 2025-12-15)
Aetna considers several vaginitis tests medically necessary for women with symptoms of vaginitis, including nucleic acid amplification or DNA probe assays for trichomonas, Candida and Gardnerella for members with dysuria or symptoms of vaginitis, sialidase activity testing such as the BVBlue test, and pH and amine testing of vaginal fluid. Screening for Trichomonas vaginalis is considered medically necessary for women with risk factors such as HIV-positive status, new or multiple partners, a history of sexually transmitted diseases, exchange of sex for payment, injection drug use, or high-prevalence settings such as STD clinics and correctional facilities. A Pap smear for the diagnosis of Candida vulvo-vaginitis, routine screening for Candida and Gardnerella in asymptomatic women, the uBiome SmartJane screen, and the 27-organism vaginal pathogen panel from Bridge Diagnostics are considered experimental, investigational, or unproven because their effectiveness has not been established.
Blue Cross & Blue Shield of Mississippi · Identified Jun 20, 2026Medium impact
Identification of Microorganisms Using Nucleic Acid Probes
Nucleic acid probe testing without quantification of viral load may be considered medically necessary for listed organisms including Bartonella henselae and quintana, Bordetella pertussis, Candida species, Chlamydia, Clostridium difficile, Herpes simplex virus, influenza virus, Mycobacterium tuberculosis, Neisseria gonorrhoeae, Streptococcus group A and group B, Trichomonas vaginalis and Zika virus. Probe testing with or without quantification may be considered medically necessary for cytomegalovirus, hepatitis B and C, HIV-1, HIV-2 and human herpes virus 6, and quantification is investigational for organisms not on that list. Nucleic acid testing with a direct or amplified probe for Gardnerella vaginalis and Hepatitis G is considered investigational, and pathogen panel testing is addressed in the Pathogen Panel Testing medical policy.

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Laboratory Payment Policies: Sept. 1, 2026 updates

Medical Policy Updates August 5, 2026

Medical and Clinical Policy Updates - Effective August 1, 2026

Laboratory Payment Policies: June 1, 2026 updates

Medical Policy Update February 11, 2026

2025 November Medical Policy Updates

Diagnosis of Vaginitis (CPB 0643, reviewed 2026-09-25)

2026 June Medical Policy Updates

Diagnosis of Vaginitis (CPB 0643, reviewed 2025-12-15)

Identification of Microorganisms Using Nucleic Acid Probes

Prior authorization required in some cases

Prior authorization required