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Blue Cross Blue Shield Oklahoma prior authorization, page 21

CPT code lookup

Each row is one code from the public prior authorization list. The description is the procedure or service name on that source row. This is not a coverage decision.

Prior authorization codes

Prior authorization codes
CodeDescriptionSource
27132Conversion Of Previous Hip Surgery To Total Hip Arthroplasty With Or Without Autograft Or Allograft2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 173 Original policy
27134Revision Of Total Hip Arthroplasty; Both Components With Or Without Autograft Or Allograft2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 173 Original policy
27137Revision Of Total Hip Arthroplasty; Acetabular Component Only With Or Without Autograft Or Allograft2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 173 Original policy
27138Revision Of Total Hip Arthroplasty; Femoral Component Only With Or Without Allograft2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 173 Original policy
27279Arthrodesis Sacroiliac Joint Percutaneous Or Minimally Invasive (Indirect Visualization) With Image Guidance Includes Obtaining Bone Graft When Performed And Placement Of Transfixing Device2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 173 Original policy
27280Arthrodesis Sacroiliac Joint Open Includes Obtaining Bone Graft Including Instrumentation When Performed2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 173 Original policy
27331Arthrotomy Knee; Including Joint Exploration Biopsy Or Removal Of Loose Or Foreign Bodies2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 173 Original policy
27332Arthrotomy With Excision Of Semilunar Cartilage (Meniscectomy) Knee; Medial Or Lateral2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 173 Original policy
27333Arthrotomy With Excision Of Semilunar Cartilage (Meniscectomy) Knee; Medial And Lateral2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27334Arthrotomy With Synovectomy Knee; Anterior Or Posterior2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27335Arthrotomy With Synovectomy Knee; Anterior And Posterior Including Popliteal Area2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27345Excision Of Synovial Cyst Of Popliteal Space (Eg Baker'S Cyst)2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27403Arthrotomy With Meniscus Repair Knee2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27405Repair Primary Torn Ligament And/Or Capsule Knee; Collateral2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27407Repair Primary Torn Ligament And/Or Capsule Knee; Cruciate2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27409Repair Primary Torn Ligament And/Or Capsule Knee; Collateral And Cruciate Ligaments2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27412Autologous Chondrocyte Implantation Knee2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27415Osteochondral Allograft Knee Open2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27416Osteochondral Autograft(S) Knee Open (Eg Mosaicplasty) (Includes Harvesting Of Autograft[S])2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27425Lateral Retinacular Release Open2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27427Ligamentous Reconstruction (Augmentation) Knee; Extra- Articular2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27428Ligamentous Reconstruction (Augmentation) Knee; Intra-Articular (Open)2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27429Ligamentous Reconstruction (Augmentation) Knee; Intra-Articular (Open) And Extra-Articular2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 174 Original policy
27437Arthroplasty Patella; Without Prosthesis2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
27438Arthroplasty Patella; With Prosthesis2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
27440Arthroplasty Knee Tibial Plateau2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
27441Arthroplasty Knee Tibial Plateau; With Debridement And Partial Synovectomy2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
27442Arthroplasty Femoral Condyles Or Tibial Plateau(S) Knee2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
27443Arthroplasty Femoral Condyles Or Tibial Plateau(S) Knee; With Debridement And Partial Synovectomy2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
27445Arthroplasty Knee Hinge Prosthesis (Eg Walldius Type)2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
27446Arthroplasty Knee Condyle And Plateau; Medial Or Lateral Compartment2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
27447Arthroplasty Knee Condyle And Plateau; Medial And Lateral Compartments With Or Without Patella Resurfacing (Total Knee Arthroplasty)2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
27486Revision Of Total Knee Arthroplasty With Or Without Allograft; 1 Component2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
27487Revision Of Total Knee Arthroplasty With Or Without Allograft; Femoral And Entire Tibial Component2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
27488Removal Of Prosthesis Including Total Knee Prosthesis Methylmethacrylate With Or Without Insertion Of Spacer Knee2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
28446Open Osteochondral Autograft Talus (Includes Obtaining Graft[S])2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 175 Original policy
29805Arthroscopy Shoulder Diagnostic With Or Without Synovial Biopsy (Separate Procedure)2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 176 Original policy
29806Arthroscopy Shoulder Surgical; Capsulorrhaphy2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 176 Original policy
29807Arthroscopy Shoulder Surgical; Repair Of Slap Lesion2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 176 Original policy
29819Arthroscopy Shoulder Surgical; With Removal Of Loose Body Or Foreign Body2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 176 Original policy
29820Arthroscopy Shoulder Surgical; Synovectomy Partial2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 176 Original policy
29821Arthroscopy Shoulder Surgical; Synovectomy Complete2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 176 Original policy
29822Arthroscopy Shoulder Surgical; Debridement Limited 1 Or 2 Discrete Structures (Eg Humeral Bone Humeral Articular Cartilage Glenoid Bone Glenoid Articular Cartilage Biceps Tendon Biceps Anchor Complex Labrum Articular Capsule Articular Side Of The Rotator Cuff Bursal Side Of The Rotator Cuff Subacromial Bursa Foreign Body[Ies])2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 176 Original policy
29823Arthroscopy Shoulder Surgical; Debridement Extensive 3 Or More Discrete Structures (Eg Humeral Bone Humeral Articular Cartilage Glenoid Bone Glenoid Articular Cartilage Biceps Tendon Biceps Anchor Complex Labrum Articular Capsule Articular Side Of The Rotator Cuff Bursal Side Of The Rotator Cuff Subacromial Bursa Foreign Body[Ies])2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 176 Original policy
29824Arthroscopy Shoulder Surgical; Distal Claviculectomy Including Distal Articular Surface (Mumford Procedure)2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 177 Original policy
29825Arthroscopy Shoulder Surgical; With Lysis And Resection Of Adhesions With Or Without Manipulation2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 177 Original policy
29826Arthroscopy Shoulder Surgical; Decompression Of Subacromial Space With Partial Acromioplasty With Coracoacromial Ligament (Ie Arch) Release When Performed (List Separately In Addition To Code For Primary Procedure)2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 177 Original policy
29827Arthroscopy Shoulder Surgical; With Rotator Cuff Repair2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 177 Original policy
29828Arthroscopy Shoulder Surgical; Biceps Tenodesis2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 177 Original policy
29860Arthroscopy Hip Diagnostic With Or Without Synovial Biopsy (Separate Procedure)2026 Commercial Outpatient Medical Surgical Fully Insured Prior Authorization Codes, Pg 177 Original policy

Sources

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.

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