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Predetermination Codes

Please review the codes that must meet BCBSOK medical policy criteria before services can be considered for benefits. Please review our medical policy criteria before rendering services. A predetermination can be requested for the services on this list.

If a predetermination is not obtained, please submit supporting medical documentation with your claim.

There are also codes that are considered not corporately covered . A predetermination is not necessary for these services.

* This is not an all inclusive listing.

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