14 commercial payer policies list 76497. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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14 policies from 12 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 76497 |
|---|---|---|
| Cigna Commercial Radiology Code List | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of 76497 |
|---|---|---|
| Cigna Commercial & Medicare Cardiology & Radiology Code List | Jan 1, 2026 | Prior auth required |
| Cigna OBM Radiology Code List |
| Jan 1, 2026 |
| Prior auth required |
| Policy | Effective | Status of 76497 |
|---|---|---|
| GHI/Emblem Non-City of New York & Medicare Radiology and Cardiology Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 76497 |
|---|---|---|
| EOCCO Cardiology & Radiology Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 76497 |
|---|---|---|
| Pediatric and Special Populations Spine Imaging Guidelines | Feb 3, 2026 | Covered with conditions |
| Policy | Effective | Status of 76497 |
|---|---|---|
| Health Alliance Plan Radiology Code List | Aug 1, 2026 | Prior auth required |
| Policy | Effective | Status of 76497 |
|---|---|---|
| Health Partners Plans Cardiology, Radiology, and Ultrasound Code List | Jul 1, 2025 | Prior auth required |
| Policy | Effective | Status of 76497 |
|---|---|---|
| Whole Body CT Screening | Oct 1, 2025 | Covered |
| Policy | Effective | Status of 76497 |
|---|---|---|
| The Health Plan Cardiology & Radiology Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 76497 |
|---|---|---|
| Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) Scan – Site of Service | Sep 1, 2026 | Covered |
| Policy | Effective | Status of 76497 |
|---|---|---|
| Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) Scan – Site of Service | Sep 1, 2026 | Covered |
| Policy | Effective | Status of 76497 |
|---|---|---|
| Gastroesophageal and Gastrointestinal (GI) Services and Procedures | Not recorded | Covered |