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Blue Cross Blue Shield Oklahoma policies, page 6

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
Infliximab and Associated BiosimilarsRX501.051 · Effective Jan 1, 2026 · Commercial, Medicaid6Original policy ↗
Infrared Therapy DevicesDME101.045 · Commercial, Medicaid3Original policy ↗
Infusion ServicesRP019 · Effective Dec 11, 2026 · Commercial, Medicaid · OK106Original policy ↗
Infusion Services v2CPCP019 · Effective Jul 18, 2025 · Commercial, Medicaid · OK92Original policy ↗
Inhaled Nitric OxideTHE801.038 · Commercial, Medicaid1Original policy ↗
Injectable Bulking Agents for the Treatment of Urinary and Fecal IncontinenceSUR710.008 · Commercial, Medicaid6Original policy ↗
Injectable Clostridial Collagenase for Fibroproliferative DisordersRX501.073 · Commercial, Medicaid9Original policy ↗
Inpatient Readmissions - Facility ServicesCPCP027 · Effective Dec 19, 2025 · Commercial, Medicaid · OK—Original policy ↗
Inpatient/Outpatient Unbundling Policy – FacilityCPCP002 · Effective Mar 13, 2026 · Commercial, Medicaid · OK—Original policy ↗
Inside the U.S. Food and Drug Administration (FDA)ADM1001.028 · Commercial, Medicaid4Original policy ↗
Insulin Potentiation TherapyTHE801.035 · Commercial, Medicaid1Original policy ↗
Interferential Current StimulationMED201.041 · Commercial, Medicaid7Original policy ↗
Intermittent Intravenous Insulin TherapyMED201.028 · Commercial, Medicaid1Original policy ↗
Interspinous and Interlaminar Stabilization/Distraction Devices (Spacers)SUR712.029 · Effective Nov 1, 2025 · Commercial, Medicaid5Original policy ↗
Interspinous Fixation (Fusion) DevicesSUR712.040 · Effective Nov 15, 2025 · Commercial, Medicaid5Original policy ↗
Interventions for Progressive ScoliosisSUR705.046 · Effective Sep 1, 2026 · Commercial, Medicaid37Original policy ↗
Intracellular Micronutrient AnalysisCPCPLAB029 · Effective Aug 8, 2025 · Commercial, Medicaid · OK26Original policy ↗
Intracellular Micronutrient AnalysisMED207.088 · Commercial, Medicaid7Original policy ↗
Intraocular Lens (IOLs) and Implantable Miniature Telescope (IMT)SUR713.025 · Commercial, Medicaid13Original policy ↗
Intraoperative Neurophysiologic Monitoring (IONM)MED205.011 · Commercial, Medicaid23Original policy ↗
Intraoperative Neurophysiology Monitoring (IONM) PolicyCPCP032 · Effective Oct 31, 2025 · Commercial, Medicaid · OK21Original policy ↗
Intraosseous Radiofrequency Nerve Ablation of the Basivertebral Nerve for the Treatment of Low Back PainSUR702.020 · Commercial, Medicaid3Original policy ↗
Intraurethral Valve Drainage Device for Impaired Detrusor ContractilityDME102.009 · Commercial, Medicaid4Original policy ↗
Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersSUR702.016 · Effective Jan 1, 2026 · Commercial, Medicaid7Original policy ↗
Intravenous Antibiotic Therapy and Associated Diagnostic Testing for Lyme DiseaseMED207.104 · Commercial, Medicaid12Original policy ↗
Intravitreal, Punctum, and Intracameral ImplantsOTH903.024 · Commercial, Medicaid12Original policy ↗
Irreversible Electroporation (IRE)SUR701.048 · Commercial, Medicaid4Original policy ↗
Islet Transplantation for Chronic Pancreatitis and Donislecel-jujn for Type 1 DiabetesSUR703.057 · Commercial, Medicaid10Original policy ↗
Isolated Small Bowel TransplantSUR703.014 · Commercial, Medicaid9Original policy ↗
KeratoprosthesisOTH903.030 · Commercial, Medicaid3Original policy ↗
Kidney TransplantSUR703.007 · Commercial, Medicaid13Original policy ↗
KidneyIntelX and KidneyIntelX.dkd TestingMED207.163 · Commercial, Medicaid2Original policy ↗
Laboratory Panel BillingRP021 · Effective Aug 21, 2026 · Commercial, Medicaid · OK49Original policy ↗
Laboratory Testing for the Diagnosis of Inflammatory Bowel DiseaseCPCPLAB035 · Effective Jan 3, 2026 · Commercial, Medicaid · OK15Original policy ↗
Laboratory Testing Investigational ServicesMED207.164 · Effective Apr 1, 2026 · Commercial, Medicaid28Original policy ↗
Lactation Support ServicesRP043 · Effective Jul 24, 2026 · Commercial, Medicaid · OK17Original policy ↗
LanreotideRX501.155 · Commercial, Medicaid2Original policy ↗
Laparoscopic, Percutaneous and Transcervical Techniques for Uterine Fibroid MyolysisSUR701.033 · Effective Jan 1, 2026 · Commercial, Medicaid8Original policy ↗
Laser Interstitial Tumor Therapy (LITT)SUR701.031 · Commercial, Medicaid13Original policy ↗
Leadless Cardiac PacemakersSUR707.030 · Effective Nov 1, 2025 · Commercial, Medicaid17Original policy ↗
Lecanemab-irmbRX501.152 · Commercial, Medicaid1Original policy ↗
Liposuction for Lipedema and LymphedemaSUR708.003 · Effective Jan 1, 2026 · Commercial, Medicaid4Original policy ↗
Liver Transplant and Combined Liver-Kidney TransplantSUR703.008 · Commercial, Medicaid24Original policy ↗
Long-Acting Injectable Antiretroviral Agents for Treatment of HIVRX501.145 · Effective Apr 1, 2026 · Commercial, Medicaid3Original policy ↗
Long-Term Ambulatory Cardiac Monitoring (Outpatient Cardiac Telemetry, Implantable Cardiac Rhythm Event Monitors, and Intracardiac Ischemia Detection Systems)MED202.003 · Effective Jan 1, 2026 · Commercial, Medicaid20Original policy ↗
Low-Level Laser TherapyMED201.045 · Commercial, Medicaid3Original policy ↗
Lower Esophageal Magnetic Sphincter AugmentationSUR709.036 · Commercial, Medicaid2Original policy ↗
Lower-Limb Prosthetics, Including Microprocessor-Controlled ProstheticsDME104.012 · Commercial, Medicaid222Original policy ↗
LumasiranRX501.133 · Effective Sep 1, 2026 · Commercial, Medicaid1Original policy ↗
Lumbar Spinal FusionSUR712.036 · Effective Jan 1, 2026 · Commercial, Medicaid37Original 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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