Blue Cross Blue Shield Oklahoma prior authorization 78430

Blue Cross Blue Shield Oklahoma prior authorization for 78430: Myocardial Imaging Positron Emission Tomography (Pet) Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S] When Performed); Single Study At Rest Or Stress (Exercise Or Pharmacologic) With Concurrently Acquired Computed Tomography Transmission Scan

Code: 78430
Description: Myocardial Imaging Positron Emission Tomography (Pet) Perfusion Study (Including Ventricular Wall Motion[S] And/Or Ejection Fraction[S] When Performed); Single Study At Rest Or Stress (Exercise Or Pharmacologic) With Concurrently Acquired Computed Tomography Transmission Scan
Source: 2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 28 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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