Blue Cross Blue Shield Oklahoma prior authorization 77373

Blue Cross Blue Shield Oklahoma prior authorization for 77373: Stereotactic Body Radiation Therapy Treatment Delivery Per Fraction To 1 Or More Lesions Including Image Guidance Entire Course Not To Exceed 5 Fractions

Code: 77373
Description: Stereotactic Body Radiation Therapy Treatment Delivery Per Fraction To 1 Or More Lesions Including Image Guidance Entire Course Not To Exceed 5 Fractions
Source: 2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 212 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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