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Blue Cross Blue Shield Oklahoma policies, page 4

Search Blue Cross Blue Shield Oklahoma's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

534 public policies Substrate tracks for Blue Cross Blue Shield Oklahoma, by title.

Blue Cross Blue Shield Oklahoma policies
PolicyDetailsCodesSource
Endovascular Procedures for Intracranial Arterial Disease (Atherosclerosis and Aneurysms)SUR701.027 · Effective Dec 1, 2025 · Commercial, Medicaid16Original policy ↗
Endovascular Stent Grafts for Disorders of the Thoracic AortaMED202.057 · Effective May 1, 2026 · Commercial, Medicaid12Original policy ↗
Enzyme-Replacement Therapy for Lysosomal Storage DisordersRX501.067 · Commercial, Medicaid20Original policy ↗
Epithelial Cell Cytology in Breast Cancer Risk AssessmentRPLAB024 · Effective Sep 4, 2026 · Commercial, Medicaid · OK5Original policy ↗
Eptinezumab-jjmrRX501.124 · Effective Apr 1, 2026 · Commercial, Medicaid1Original policy ↗
Erythropoiesis-Stimulating Agents (ESAs)RX501.069 · Effective Jan 1, 2026 · Commercial, Medicaid9Original policy ↗
Esketamine Nasal SprayRX501.105 · Commercial, Medicaid5Original policy ↗
Esophageal pH MonitoringMED201.005 · Commercial, Medicaid5Original policy ↗
Etranacogene dezaparvovec-drlbRX501.151 · Effective Jan 1, 2026 · Commercial, Medicaid4Original policy ↗
Etuvetidigene autotemcelRX501.191 · Commercial, Medicaid1Original policy ↗
Evaluation and Management Coding – Professional Provider ServicesCPCP024 · Effective Feb 23, 2026 · Commercial, Medicaid · OK38Original policy ↗
Evaluation of Dry EyesRPLAB043 · Effective Sep 4, 2026 · Commercial, Medicaid · OK4Original policy ↗
Evinacumab-dgnbRX501.136 · Commercial, Medicaid1Original policy ↗
External Counterpulsation (ECP) Therapy for Severe AnginaMED202.050 · Effective May 15, 2026 · Commercial, Medicaid2Original policy ↗
Extracorporeal PhotopheresisTHE801.026 · Commercial, Medicaid1Original policy ↗
Extracorporeal Shock Wave Treatment for Plantar Fasciitis and Other Musculoskeletal ConditionsSUR705.018 · Effective Nov 1, 2025 · Commercial, Medicaid6Original policy ↗
Extracranial Carotid Angioplasty or StentingSUR701.028 · Commercial, Medicaid5Original policy ↗
Eyelid Thermal Pulsation for the Treatment of Dry Eye SyndromeOTH903.025 · Effective Jul 1, 2026 · Commercial, Medicaid4Original policy ↗
Facet ArthroplastySUR712.034 · Commercial, Medicaid2Original policy ↗
Facet Joint and Sacroiliac Joint DenervationSUR702.017 · Commercial, Medicaid6Original policy ↗
Facet Joint InjectionsSUR702.015 · Commercial, Medicaid13Original policy ↗
Faricimab-svoaOTH903.044 · Commercial, Medicaid2Original policy ↗
FDA - Drugs, Biologicals, Cellular and Gene TherapiesRX501.087 · Commercial, Medicaid6Original policy ↗
Fecal Analysis in the Diagnosis of Intestinal DysbiosisMED207.118 · Effective May 15, 2026 · Commercial, Medicaid—Original policy ↗
Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant TestingCPCPLAB025 · Effective Jan 3, 2026 · Commercial, Medicaid · OK30Original policy ↗
Fecal Calprotectin Testing in AdultsCPCPLAB026 · Effective Oct 3, 2025 · Commercial, Medicaid · OK1Original policy ↗
Fecal Microbiota Transplantation (FMT)SUR703.049 · Commercial, Medicaid4Original policy ↗
Fetal Surgery for Prenatally Diagnosed MalformationsSUR701.016 · Commercial, Medicaid13Original policy ↗
Flow CytometryRPLAB001 · Effective Sep 4, 2026 · Commercial, Medicaid · OK13Original policy ↗
Focal Treatments for Prostate CancerSUR717.004 · Commercial, Medicaid6Original policy ↗
Folate TestingRPLAB048 · Effective Sep 4, 2026 · Commercial, Medicaid · OK3Original policy ↗
Functional Neuromuscular Electrical StimulationMED201.033 · Effective Aug 1, 2025 · Commercial, Medicaid7Original policy ↗
Gamma-glutamyl Transferase Testing in AdultsCPCPLAB056 · Effective Jan 3, 2026 · Commercial, Medicaid · OK1Original policy ↗
Gamma-glutamyl Transferase Testing in AdultsRPLAB056 · Effective Dec 4, 2026 · Commercial, Medicaid · OK1Original policy ↗
Gastrointestinal Pathogen PanelsMED207.155 · Commercial, Medicaid5Original policy ↗
Gender Assignment Surgery and Gender Reassignment Surgery with Related ServicesSUR717.001 · Commercial, Medicaid127Original policy ↗
Gene Therapies for Metachromatic LeukodystrophyRX501.171 · Effective Dec 15, 2025 · Commercial, Medicaid1Original policy ↗
Gene Therapies for Sickle Cell DiseaseRX501.167 · Effective Sep 15, 2026 · Commercial, Medicaid2Original policy ↗
Gene Therapies for ThalassemiaRX501.166 · Effective Sep 1, 2026 · Commercial, Medicaid2Original policy ↗
Gene Therapies for Treatment of Wounds in Dystrophic Epidermolysis BullosaRX501.164 · Effective Jun 15, 2026 · Commercial, Medicaid2Original policy ↗
Gene Therapy for Aromatic L-amino Acid Decarboxylase DeficiencyRX501.178 · Effective Nov 15, 2025 · Commercial, Medicaid3Original policy ↗
Gene Therapy for Inherited Retinal DystrophyRX501.098 · Effective Aug 1, 2026 · Commercial, Medicaid3Original policy ↗
General Inflammation TestingCPCPLAB049 · Effective Nov 7, 2025 · Commercial, Medicaid · OK4Original policy ↗
General Inflammation TestingRPLAB049 · Effective Dec 4, 2026 · Commercial, Medicaid · OK4Original policy ↗
Genicular Artery EmbolizationSUR705.048 · Effective Jul 15, 2025 · Commercial, Medicaid5Original policy ↗
Givosiran for Acute Hepatic PorphyriaRX501.125 · Effective Nov 1, 2025 · Commercial, Medicaid1Original policy ↗
Global Obstetrical/OB Maternity Services PolicyRP044 · Effective May 22, 2026 · Commercial, Medicaid · OK34Original policy ↗
Global Surgical Package – Professional ProviderRP014 · Effective Apr 10, 2026 · Commercial, Medicaid · OK5Original policy ↗
GolimumabRX501.112 · Commercial, Medicaid1Original policy ↗
Gonadotropin-Releasing Hormone (GnRH) Agonists and AntagonistsRX501.041 · Commercial, Medicaid12Original policy ↗

Back to Blue Cross Blue Shield Oklahoma · Blue Cross Blue Shield Oklahoma prior authorization CPT list

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.

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