Blue Cross Blue Shield Oklahoma prior authorization 75573
Blue Cross Blue Shield Oklahoma prior authorization for 75573: Computed Tomography Heart With Contrast Material For Evaluation Of Cardiac Structure And Morphology In The Setting Of Congenital Heart Disease (Including 3D Image Postprocessing Assessment Of Left Ventricular [Lv] Cardiac Function Right Ventricular [Rv] Structure And Function And Evaluation Of Vascular Structures If Performed)
- Code
- 75573
- Description
- Computed Tomography Heart With Contrast Material For Evaluation Of Cardiac Structure And Morphology In The Setting Of Congenital Heart Disease (Including 3D Image Postprocessing Assessment Of Left Ventricular [Lv] Cardiac Function Right Ventricular [Rv] Structure And Function And Evaluation Of Vascular Structures If Performed)
- Source
- 2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 27 Original policy