Blue Cross Blue Shield Oklahoma prior authorization L5857

Blue Cross Blue Shield Oklahoma prior authorization for L5857: Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type

Code: L5857
Description: Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type
Source: 2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 251 Original policy

Blue Cross Blue Shield Oklahoma prior authorization

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