Talk to Us

Blue Cross Blue Shield Oklahoma prior authorization, page 30

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
B9004Parenteral Nutrition Infusion Pump Portable2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 202 Original policy
B9006Parenteral Nutrition Infusion Pump Stationary2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 202 Original policy
B9998Noc For Enteral Supplies2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 203 Original policy
B9999Noc For Parenteral Supplies2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 203 Original policy
E0779Amb Infusion Pump Mechanical2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 205 Original policy
E0780Mech Amb Infusion Pump <8Hrs2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 205 Original policy
E0781Ambulatory Infusion Pump Single Or Multiple Channels Electric Or Battery Operated With Administrative Equipment Worn By Patient2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 205 Original policy
E0782Infusion Pump Implantable Non-Programmable (Includes All Components E. G. Pump Catheter Connectors Etc. )2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 205 Original policy
E0783Infusion Pump System Implantable Programmable (Includes All Components E. G. Pump Catheter Connectors Etc. )2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 205 Original policy
E0784External Ambulatory Infusion Pump Insulin2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 205 Original policy
E0791Parenteral Infusion Pump Sta2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 205 Original policy
G0277Hyperbaric Oxygen Under Pressure Full Body Chamber Per 30 Minute Interval2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 206 Original policy
K0455Infusion Pump Used For Uninterrupted Parenteral Administration Of Medication (E. G. Epoprostenol Or Treprostinol)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 209 Original policy
Q0081Infusion Ther Other Than Che2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 210 Original policy
Q0083Chemo By Other Than Infusion2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 210 Original policy
Q0084Chemotherapy By Infusion2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 210 Original policy
Q0085Chemo By Both Infusion And O2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 210 Original policy
S5035Home Infusion Therapy Routine Service Of Infusion Device (E. G. Pump Maintenance)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 213 Original policy
S5036Home Infusion Therapy Repair Of Infusion Device (E. G. Pump Repair)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 213 Original policy
S5497Home Infusion Therapy Catheter Care / Maintenance Not Otherwise Classified; Includes Administrative Services Professional Pharmacy Services Care Coordination And All Necessary Supplies And Equipment (Drugs And Nursing Visits Coded Separately) Per Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 213 Original policy
S5498Hit Simple Cath Care2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 213 Original policy
S5517Hit Declotting Kit2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 214 Original policy
S5518Hit Cath Repair Kit2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 214 Original policy
S5520Hit Picc Insert Kit2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 214 Original policy
S5521Hit Midline Cath Insert Kit2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 214 Original policy
S5522Hit Picc Insert No Supp2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 214 Original policy
S5523Hip Midline Cath Insert Kit2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 214 Original policy
S9061Medical Supplies And Equipme2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 214 Original policy
S9326Home infusion therapy, continuous (twenty-four hours or more) pain management infusion; administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 216 Original policy
S9327Home infusion therapy, intermittent (less than twenty-four hours) pain management infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 216 Original policy
S9328Hit Pain Imp Pump Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 216 Original policy
S9329Home infusion therapy, chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (do not use this code with s9330 or s9331)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 217 Original policy
S9330Home infusion therapy, continuous (twenty-four hours or more) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 217 Original policy
S9331Home infusion therapy, intermittent (less than twenty-four hours) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 217 Original policy
S9336Home infusion therapy, continuous anticoagulant infusion therapy (e. G. Heparin), administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 217 Original policy
S9338Hit Immunotherapy Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 217 Original policy
S9339Home therapy; peritoneal dialysis, administrative services, professional pharmacy services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 218 Original policy
S9340Home Therapy; Enteral Nutrition; Administrative Services Professional Pharmacy Services Care Coordination And All Necessary Supplies And Equipment (Enteral Formula And Nursing Visits Coded Separately) Per Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 218 Original policy
S9341Home Therapy; Enteral Nutrition Via Gravity; Administrative Services Professional Pharmacy Services Care Coordination And All Necessary Supplies And Equipment (Enteral Formula And Nursing Visits Coded Separately) Per Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 218 Original policy
S9342Home Therapy; Enteral Nutrition Via Pump; Administrative Services Professional Pharmacy Services Care Coordination And All Necessary Supplies And Equipment (Enteral Formula And Nursing Visits Coded Separately) Per Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 218 Original policy
S9343Home Therapy; Enteral Nutrition Via Bolus; Administrative Services Professional Pharmacy Services Care Coordination And All Necessary Supplies And Equipment (Enteral Formula And Nursing Visits Coded Separately) Per Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 218 Original policy
S9345Home infusion therapy, anti-hemophilic agent infusion therapy (e. G. Factor viii); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 219 Original policy
S9346Hit Alpha-1-Proteinas Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 219 Original policy
S9347Home infusion therapy, uninterrupted, long-term, controlled rate intravenous or subcutaneous infusion therapy (e. G. Epoprostenol); administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 219 Original policy
S9348Home infusion therapy, sympathomimetic/inotropic agent infusion therapy (e. G. , dobutamine); administrative services, professional pharmacy services, care coordination, all necessary supplies and equipment (drugs and nursing visits coded separately), per diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 219 Original policy
S9349Hit Tocolysis Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 219 Original policy
S9351Hit Cont Antiemetic Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 219 Original policy
S9353Hit Cont Insulin Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 219 Original policy
S9355Home Infusion Therapy Chelation Therapy; Administrative Services Professional Pharmacy Services Care Coordination And All Necessary Supplies And Equipment (Drugs And Nursing Visits Coded Separately) Per Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 219 Original policy
S9361Hit Diuretic Infus Diem2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 220 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.

This website uses cookies to ensure you get the best experience on our website. Learn more