Blue Cross Blue Shield Oklahoma prior authorization 54417

Blue Cross Blue Shield Oklahoma prior authorization for 54417: Removal and replacement of non-inflatable (semi rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue

Code: 54417
Description: Removal and replacement of non-inflatable (semi rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue
Source: 2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 238 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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