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Blue Cross Blue Shield Oklahoma prior authorization, page 32

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
15825Rhytidectomy; neck with platysmal tightening (platysmal flap, P-flap)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 229 Original policy
15828Rhytidectomy; cheek, chin, and neck2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 229 Original policy
15830Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 229 Original policy
15832Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 229 Original policy
15833Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 229 Original policy
15834Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 229 Original policy
15835Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 229 Original policy
15836Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 229 Original policy
15837Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 229 Original policy
15838Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 229 Original policy
15839Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 229 Original policy
15847Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg, abdominoplasty) (includes umbilical transposition and fascial plication) (List separately in addition to code for primary procedure)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 229 Original policy
15876Suction assisted lipectomy; head and neck2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 230 Original policy
15877Suction assisted lipectomy; trunk2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 230 Original policy
15878Suction assisted lipectomy; upper extremity2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 230 Original policy
15879Suction assisted lipectomy; lower extremity2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 230 Original policy
19300Mastectomy for gynecomastia2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 230 Original policy
19303Mastectomy, simple, complete2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 230 Original policy
19325Breast augmentation with implant2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 230 Original policy
19371Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 230 Original policy
33274Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, fe2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 230 Original policy
33285Insertion, subcutaneous cardiac rhythm monitor, including programming2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 230 Original policy
33289Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring, including deployment and calibration of the sensor, right heart catheterization, selective pulmonary catheterization, radiological supervision and interpretation, and pulmonary artery angiography, when performed2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 230 Original policy
33928Removal and replacement of total replacement heart system (artificial heart)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 231 Original policy
33982Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 231 Original policy
36465Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 231 Original policy
36466Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 231 Original policy
36468Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 231 Original policy
36470Injection of sclerosant; single incompetent vein (other than telangiectasia)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 231 Original policy
36471Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 231 Original policy
36475Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 231 Original policy
36476Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 232 Original policy
36478Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 232 Original policy
36479Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 232 Original policy
36482Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 232 Original policy
36483Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access sites (List separately in addition to code for primary procedure)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 233 Original policy
37241Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 233 Original policy
37242Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, other than hemorrhage or tumor (eg, congenital or acquired arterial malformations, arteriovenous malformations, arteriovenous fistulas, aneurysms, pseudoaneurysms)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 233 Original policy
37243Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 234 Original policy
37500Vascular endoscopy, surgical, with ligation of perforator veins, subfascial (SEPS)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 234 Original policy
37700Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 234 Original policy
37718Ligation, division, and stripping, short saphenous vein2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 234 Original policy
37722Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 234 Original policy
37735Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of deep fascia2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 234 Original policy
37760Ligation of perforator veins, subfascial, radical (Linton type), including skin graft, when performed, open,1 leg2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 234 Original policy
37761Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 234 Original policy
37765Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 234 Original policy
37766Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 234 Original policy
37780Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 235 Original policy
37785Ligation, division, and/or excision of varicose vein cluster(s), 1 leg2026 Commercial Outpatient Medical Surgical ASO Prior Authorization Codes, Pg 235 Original policy

Sources

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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.

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